Sample records for bronchopneumonia

  1. Hemorrhagic Bronchopneumonia in Adults with Chickenpox. A Case Report

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    Miguel Ángel Serra Valdés


    Full Text Available Chickenpox is an acute viral infectious disease that is highly contagious and very common in children. When it occurs in adults, age increases severity, with complications that can lead to death in a short period of time. Among the most lethal complications we can find pneumonia and bronchopneumonia, injuries overinfection caused by streptococci and staphylococci with severe sepsis, diverse bleeding, encephalitis, shock, hemorrhagic nephritis with renal failure and necrotizing fasciitis, among others. The case of an 83 years old male patient, with a history of chronic obstructive pulmonary disease and ischemic cerebrovascular atherosclerotic disease that contracted chickenpox and whose evolution was very rapid, with acute respiratory failure and bronchopneumonia massive hemorrhagic shock, to the point of death, is presented. Given the increased incidence of chickenpox, according to reports of the Pedro Kouri Institute of Tropical Medicine, we decided to have this case published.

  2. An aetiopathological study of chronic bronchopneumonia in lambs in Ireland. (United States)

    Sheehan, Maresa; Cassidy, Joseph P; Brady, Joseph; Ball, Hywel; Doherty, Michael L; Quinn, Patrick J; Nicholas, Robin A J; Markey, Bryan K


    Chronic bronchopneumonia in lambs, also known as 'atypical' or 'chronic, non-progressive' pneumonia is a common, frequently sub-clinical disease affecting animals under 12-months-old in intensive production systems. Infection with both Mycoplasma ovipneumoniae and Mannheimia haemolytica have been implicated in the aetiology of this condition and a variety of pulmonary lesions can result. In this study, detailed laboratory examination of 30 abattoir-derived lungs with the characteristic gross features of atypical pneumonia (AP) was carried out with a view to refining and correlating the histopathological and microbiological criteria required for the diagnosis of this disease. For the first time a broad range of laboratory detection techniques including bacterial and virus isolation, fluorescent antibody tests and immunohistochemistry were used in parallel to identify potential causative pathogens such as M. ovipneumoniae, M. haemolytica, parainfluenza type-3 (PI3) virus and respiratory syncytial virus (RSV) in AP lesions. The most consistent finding was the association of gross AP lesions with M. ovipneumoniae, identified by either culture or immunohistochemistry in 27 (90%) of the 30 cases. However the presence M. ovipneumoniae organisms or antigen did not consistently correlate with particular histopathological changes. Furthermore, peri-airway lymphoid hyperplasia, intra-alveolar exudation and nodular 'hyaline scars', which are all previously reported microscopic lesions of AP, were not identified in 12 (40%) of the cases and isolation of M. haemolytica was over-represented in lungs exhibiting suppurative lesions. These findings illustrate the complex aetiopathogenesis of this disease and highlight the requirement to use a combination of diagnostic criteria in its laboratory diagnosis.

  3. Fatal bronchopneumonia in a Metastrongylus elongatus and Porcine circovirus type 2 co-infected pig. (United States)

    Marruchella, G; Paoletti, B; Speranza, R; Di Guardo, G


    Porcine circovirus type 2 (PCV2) infection is distributed worldwide and PCV2-associated disease (PCVAD) is considered among the most economically relevant ones to the global swine industry. PCV2 is known to play a causal role in the porcine respiratory disease complex, usually in close association with a large plethora of other biologic agents. We describe herein a case of fatal parasitic bronchopneumonia by Metastrongylus elongatus in a PCV2-infected pig. Metastrongylosis may still represent a major concern for outdoor herds. Our recent experience suggests that a concurrent PCVAD condition may trigger metastrongylosis, which may subsequently result, at its turn, in severe, sometimes fatal, pulmonary disease.

  4. Partial resolution of hypoplastic trachea in six english bulldog puppies with bronchopneumonia. (United States)

    Clarke, Dana L; Holt, David E; King, Lesley G


    Six English bulldog and nine nonbrachycephalic puppies with bronchopneumonia and radiographs were evaluated. Relative size of the trachea was measured by the tracheal diameter (TD) and the thoracic inlet distance (TI), expressed as a ratio (TD:TI). At diagnosis of bronchopneumonia, there was a significant difference between the median TD:TI of the bulldog puppies (0.07; range, 0.06-0.09) and that of the nonbrachycephalic puppies (0.14; range, 0.11-0.25; P=0.0004). At the same time, there was also a significant difference between the mean TD:TI of bulldog puppies (0.07±0.01) and that of nonbrachycephalic puppies (0.15±0.05; P=0.002). Follow-up radiographs showed significant increases in TD:TI ratio in all six bulldogs (median TD:TI = 0.14; range, 0.12-0.18; P=0.03 and mean TD:TI = 0.15±0.02; P=0.0007), whereas the ratio did not change significantly in the nonbrachycephalic control group (median TD:TI = 0.17; range, 0.14-0.22; P=0.10 and mean TD:TI = 0.18±0.03; P=0.06). Tracheal hypoplasia in some brachycephalic dogs might partially or completely resolve with growth to mature body size.

  5. Advanced chronic lymphoid leukemia with severe bronchopneumonia: an Autopsy Case Report (United States)

    Amaral, Felipe Gomes Campos; Lima, Luiz Guilherme Cernaglia Aureliano; Hatanaka, Veruska Menegatti Anastacio; Siqueira, Sheila Aparecida Coelho


    Chronic lymphocytic leukemia (CLL) is a lymphoid neoplasia with the B immunophenotype, which corresponds to the leukemic form of lymphocytic lymphoma. This entity is characterized, in most cases, by immunosuppression due to impaired function of immune cells, hypogammaglobulinemia, bone marrow infiltration, and immune dysfunction due to the neoplasia and the chemotherapy, when prescribed. We describe the case of a 63-year-old woman with a previous diagnosis of advanced CLL, refractory to treatment, who presented respiratory failure at the emergency department and died soon after hospital admission. The autopsy examination showed a large retroperitoneal mass compressing large vessels and abdominal and pelvic organs; generalized lymphadenopathy; and liver, spleen, bone marrow, heart and kidney infiltration. A Gram-negative bacilli bronchopneumonia with diffuse alveolar damage was detected, which was likely to be the immediate cause of death. PMID:27284536

  6. Effect of aerosol inhalation of ipratropium bromide combined with budesonide and terbutaline on cytokines in children with bronchopneumonia

    Institute of Scientific and Technical Information of China (English)

    Xiang-Yu Che


    Objective:To explore the clinical efficacy of aerosol inhalation of ipratropium bromide combined with budesonide and terbutaline in the treatment of bronchopneumonia in children and the effect on cytokines.Methods:A total of 70 children with bronchopneumonia who were admitted in our hospital from March, 2015 to March, 2016 were included in the study and randomized into the study group and the control group. The patients in the control group were given anti-infection, oxygen inhalation, cough and asthma relieving, acidosis correcting, mask+oxygen driven aerosol inhalation of budesonide (0.5 mg/time) and terbutaline (1.0 mg/time), with an oxygen flow rate of 5-7 L/min, 5-10 min every time, twice a day. On the above basis, the patients in the study group were given additional ipratropium bromide (1.0 mg/time). After 7-day treatment, the efficacy was evaluated. The levels of IL-6, TNF-α, CRP, and WBC before and after treatment were detected. PEF, FVC, and FEV1 before and after treatment were detected. The improvement of clinical symptoms and signs, and the occurrence of adverse reactions were observed.Results: The levels of IL-6, TNF-α, CRP, and WBC counting after treatment in the two groups were significantly reduced when compared with before treatment (P0.05).Conclusions:Ipratropium bromide combined with budesonide and terbutaline in the treatment of bronchopneumonia in children can rapidly relieve the symptoms, and improve the cytokine level, without obvious adverse reactions; therefore, it deserves to be widely recommended in the clinic.


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    Daniel Pessoa Gomes da Silva


    Full Text Available Com o propósito de avaliar a segurança, a eficácia diagnóstica da biópsia pulmonar e comparar a possível ocorrência de complicações decorrentes da técnica, entre bezerros sadios e com broncopneumonia induzida, utilizaram-se dez bezerros (G1 sadios e vinte bezerros portadores de broncopneumonia, divididos em quatro grupos de cinco bezerros (G2 a G5, os quais foram biopsiados 12, 24, 48 e 72 horas após a inoculação com Mannheimia haemolytica, respectivamente. A presença de crepitação grossa, som submaciço à percussão e as alterações radiográficas auxiliaram no diagnóstico da broncopneumonia e localizaram a área pulmonar a ser biopsiada nos grupos G2 a G5. As alterações microscópicas, visualizadas nos animais do grupo G2 a G5, foram as de broncopneumonia fibrinopurulenta. Nos bezerros do grupo G1 as alterações relacionadas à técnica foram: tosse, epistaxe, dispneia mista, taquipneia e taquicardia. Cinco (25% bezerros com broncopneumonia desenvolveram hemotórax após a biópsia e as alterações relacionadas à técnica foram: taquipneia, taquicardia, tosse, dispneia mista, apatia, mucosas pálidas e decúbito. Conclui-se que a biópsia pulmonar permite o diagnóstico de broncopneumonia em bezerros, contudo as complicações decorrentes da técnica limitam o seu uso apenas nas situações em que os métodos convencionais não tenham possibilitado o diagnóstico.

    PALAVRAS-CHAVES: Bezerros, biópsia pulmonar, broncopneumonia, Mannheimia haemolytica.

    The purpose of this study was to evaluate the safety and diagnostic efficacy of lung biopsy and to compare the possible occurrence of complications due to this technique in healthy calves and in calves with bronchopneumonia. Thirty Holstein calves were divided into a group of ten healthy animals (G1 and into four experimental groups (G2 to G5 of five calves each

  8. 老年支气管肺炎患者雾化吸入方法的探讨%The atomization inhalation in older patients with bronchopneumonia

    Institute of Scientific and Technical Information of China (English)



    目的 探讨使用氨溴索进行雾化吸入治疗老年支气管肺炎的最佳方法.方法 将29例患者随机分成2组,分别采用氧气雾化和超声雾化两种不同的雾化方法,比较两组雾化吸入后症状缓解的例数、雾化时间、交叉感染情况.结果 氧气雾化吸入方法时间短、效果好,无交叉感染现象,优于超声雾化吸入方法.结论 应用氨溴索氧气雾化吸入方法更适用于老年支气管肺炎患者,患者感觉舒适,容易接受,值得推广应用.%Objective To explore the best method of aerosol inhalation with ambroxol on treating the patients with bronchopneumonia. Methods Twenty- nine cases of patients were randomly divided into two groups, using oxygen atomization method or ultrasonic atomization method respectively. Cases reaching symptomatic relief after aerosol inhalation, the average treatment time,and condition of cross infection between the two groups were compared. Results The method of oxygen atomization is superior to the method of ultrasonic atomization, with shorter treating time,better effect, and no cross- infection phenomenon. Conclusion The method of oxygen atomization with ambroxol is more suitable for old patients with bronchopneumonia, and it is worth popularizing because patients feel comfortable and easy to accept.

  9. 综合性护理干预在小儿支气管肺炎中的临床效果观察%Observation of clinical effects of comprehensive nursing intervention in pediatric bronchopneumonia

    Institute of Scientific and Technical Information of China (English)



    Objective To discuss the value of comprehensive nursing intervention during the rehabilitation of pediatric bronchopneumonia. Methods A total of 80 children patients with bronchopneumonia were randomLy assigned to exper-iment group and control group. 45 patients in the experiment group were given comprehensive nursing interventions such as ultrasonic aerosol inhalation, postural drainage and thoracic and dorsal percussion on the basis of original nurs-ing of treatment; 35 patients in the control group were given regular nursing. Results Cough, fever, duration of pul-monary moist rales and hospitalization time between the two groups of children patients all showed significant differ-ences (P<0.05), and the experiment group was significantly better than the control group. Conclusion comprehensive Nursing intervention is beneficial in reducing complications and has a significant effect. It is easy and convenient to operate, is highly safe and is able to reduce toxic and side effects. It is able to significantly promote early recovery of health for children patients with bronchopneumonia, which is worthy of widespread promotion in clinical nursing care.%目的:探讨综合性护理干预在小儿支气管肺炎康复疗效过程中的价值。方法随机将80例支气管肺炎患儿分为实验组和对照组:实验组45例,在原治疗护理基础上加用超声雾化吸入、体位引流、胸背部扣击等综合护理干预方法;对照组35例,给予常规护理。结果两组患儿在咳嗽、发热、肺部湿啰音体征持续时间及住院时间上均有显著差异(P<0.05),实验组明显优于对照组。结论综合性护理干预有利于减少并发症,效果显著,操作方便简单,安全性高,减少毒副作用,能显著促进支气管肺炎患儿尽早恢复健康,在临床护理工作中值得广泛推广。

  10. Changes of Tidal Pulmonary Function in Children with Thrombocytosis in Bronchopneumonia%支气管肺炎伴血小板增多患儿潮气呼吸肺功能的改变

    Institute of Scientific and Technical Information of China (English)

    孙激扬; 季伟; 周卫芳; 陈正荣


    目的 探讨支气管肺炎伴外周血血小板计数增高(ST)患儿潮气呼吸肺功能的改变.方法 比较28例支气管肺炎伴血小板增多的患儿(A组)与33例支气管肺炎血小板计数正常的患儿(B组)的潮气呼吸肺功能.结果 A组代表小气道阻塞的肺功能指标呼气达峰时间(tPTEF)、达峰时间比(呼气达峰时间/呼气时间,tPTEWtE)、剩余25%潮气量时的呼气流速(TEF25)、剩余25%潮气量时的呼气流速/呼气峰流速(TEF25/PTEF)较B组显著降低(均P<0.01),且tPTEF/tE、TEF25与血小板计数成负相关(r分别为-0 461、-0.407,均P<0.05).代表通气功能的每公斤潮气量( VT/kg)指标两组差异无统计学意义(P<0.05).结论 肺炎伴血小板增多患儿小气道阻塞程度较血小板计数正常者严重,外周血血小板计数可作为预测支气管肺炎患儿小气道阻塞程度的有效指标之一.%Objective To explore the changes of tidal pulmonary function in paediatric patients with thrombocylosis in bronchopneumonia. Methods Twenty eight patients with thrumbocytosis in broncho-pneumonia (group A) were measured and recorded the lung function parameters by V26 max pulmonary function testing( PFT) machine. Campared with agematched 33 patients with nomal platelet counts in bron-chopneumonia( group B). Results Compared with group B, the lung function parameter including time of peak tidal expiratory flow (tPTEF) ,the ratio of exhaled time at PTEF to total expiratory time(tPTEF/ tE) ,tidal expiratory flow at 25% of the remaining tidal volume(TEF25 )and the ratio of TEF25 to PTEF ( TEF25/PTEF % ) decreased in group A. The difference between the two groups was statistically significant (P<0.01). The platelet count with two kinds of pulmonary function parameters ( tPTEF/tE,TEF25 )was negatively correlated. (r= -0.461,r= -0. 407 ,P <0. 05). Conclusion The severity of pulmonary function damage in pneumonia in chidren is associated with the platelet count. The platelet

  11. Research study on antibiotic application for bronchopneumonia of the children in-patient in pediatrics in 2010%2010年儿科支气管肺炎(住院)抗生素应用调查研究

    Institute of Scientific and Technical Information of China (English)

    陈娟; 文智惠


    目的 调查分析本院儿科2010年支气管肺炎(住院)患者抗生素应用情况,供儿科医师临床工作中合理使用抗生素提供参考.方法 应用回顾性调查研究方法,提取本院2010年儿科支气管肺炎住院病例341例,对抗生素使用情况进行统计和分析.从计算机数据库调取病例及相关数据,对儿科支气管肺炎住院病人抗生素用药品种及使用率、用药剂最及用药次数、对患儿不同白细胞水平抗生素使用情况进行调查统计、对病原体送检率、联合使用情况等进行统计分析.结果 儿科支气管肺炎(住院)病人抗生素使用率过高,341病例中,共328例(96.18%)应用抗生素,严重超出卫生部(<50%)和WHO(< 30%)标准;口服药品使用比例低,患儿住院期间使用的抗生素均为静脉用药,口服抗生素均为出院带药;抗生素剂量及次数不合理;病原学检查不及时,仅101例(29.62%)行病原学检查,低于卫生部标准(>30%).结论 儿科医生应加强对支气管肺炎(住院)病人抗生素用药的重视,根据病原学检查结果,安全、有效、合理选择用药品种、用药方式,正确选择抗生素剂量及次数,使疾病治疗由经验治疗转为病原治疗.%Objective To investigate and analyze the status of the antibiotics usage in bronchopneumonia of the children in-patient in pediatrics in 2010 and provide the reference for clinic.Methods By using the retrospective study method,341 cases of bronchopneumonia of the children in-patient in pediatrics in our hospital during 2010 were selected to start and analyze the usage of antibiotics.The cases and related data were taken from the computer database and statistically analyzed,the kinds of drugs,the using ratio,the dosage and times of antibiotic drugs were investigated.The patients were divided into different groups as the different severity of the disease(WBC level) and the antibiotics usage in each group was surveyed.Data of

  12. Clinical significance of serum myocardial enzyme spectrum, C-reactive protein and blood platelet count in diagnosis of children bronchopneumonia%血清心肌酶谱、C-反应蛋白和血小板计数变化在儿童支气管肺炎诊断中的临床意义

    Institute of Scientific and Technical Information of China (English)

    冼中任; 陈燕


    Objective To research clinical significance of serum myocardial enzyme spectrum, C-reactive (CRP) protein and blood platelet count (PLT) in diagnosis of children bronchopneumonia. Methods There were 175 children with bronchopneumonia as experimental group, Among them, there were 100 mild cases, 75 severe cases, and 110 bacteria-type cases, 50 virus-type cases, 15 microbe-type cases. There were another 100 healthy children as control group. Their changed serum myocardial enzyme spectrum was examined by enzyme kinetics, changed C-reactive protein was detected by immunity transmission turbidity, and changed blood platelet count was detected by blood routine test, and all received statistical analysis.Results The experimental group had all higher serum myocardial enzyme spectrum, C-reactive protein and blood platelet count than the control group. These three indexes of severe cases were all higher than mild cases. CRP was increased in bacteria-type, and their difference had statistical significance (P<0.05).Conclusion Changes of serum myocardial enzyme spectrum, C-reactive protein and blood platelet count is helpful for diagnosis of children bronchopneumonia. This method contains high sensitivity, wide feasibility, convenience and economical advantage, and it is worthy of clinical promotion.%目的 研究血清心肌酶谱、C-反应蛋白(CRP)和血小板计数(PLT)变化在儿童支气管肺炎诊断中的临床意义.方法 选取175例支气管肺炎患儿, 其中轻型100例, 重型75例;细菌型110例, 病毒型50例, 微生物型15例.并选取100例正常儿童作为对照.均使用酶动力学检查血清心肌酶谱变化;选择免疫透射比浊法测定C-反应蛋白变化;血常规测定血小板计数的变化, 并进行统计分析.结果 支气管肺炎患儿血清心肌酶谱、C-反应蛋白和血小板计数均高于正常儿童;重型支气管肺炎患儿三项指标均高于轻型;细菌型CRP显著增高, 差异均具有统计学意义(P<0.05).

  13. The Therapeutic Effect and safety of Meropenem and cefoperazone/sulbactam On ESBLs causing Bronchopneumonia in Pediatrics%美罗培南与头孢哌酮-舒巴坦治疗儿科产 ESBLs 菌致支气管肺炎的临床疗效及安全性评价

    Institute of Scientific and Technical Information of China (English)

    韦鸿雁; 谭波宇; 邓楠


    目的:评价美罗培南与头孢哌酮-舒巴坦治疗儿科产超广谱β-内酰胺酶(ESBLs)耐药菌致支气管肺炎的临床疗效及安全性。方法:入选186例患儿病例,按用药情况分为美罗培南组与头孢哌酮-舒巴坦组,进行回顾性统计研究。采用 spss 22.0统计软件进行数据处理,用 t 检验或χ2检验,比较两组间的基本资料齐同性,统计菌群分布及耐药率,分别计算细菌清除率、治疗有效率及抗菌药物费用。结果:两组病例中共分离细菌186株,主要产 ESBLs 菌为大肠埃希菌(56.99%)和肺炎克雷伯菌(37.63%)。美罗培南组与头孢哌酮-舒巴坦组治疗儿科产ESBLs 菌致支气管肺炎的细菌清除率分别为86.95%及57.44%,总有效率分别为82.60%和87.23%。日平均费用美罗培南组是头孢哌酮-舒巴坦组的7.5倍。结论:美罗培南与头孢哌酮-舒巴坦治疗产 ESBLs 菌致支气管肺炎疗效确切,不良反应发生率低。对产 ESBLs 菌致患儿支气管肺炎首选美罗培南,头孢哌酮-舒巴坦可作为降阶治疗的备选药物。%Objective To evaluate the efficacy and safety of meropenem and cefoperazone/sulbactam on producing Ex-tended Spectrum Beta-Lactamases (ESBLs) bacterias causing bronchopneumonia in pediatrics. Methods 186 patients were enrolled according to inclusive criteria, and divided into meropenem and cefoperazone/sulbactam group. Retrospective statisti-cal studies was carried on and spss22.0 was used to make t test and x2 test between two groups. Comparison between the two groups of the basic information of his gay, and statistics and flora distribution, and resistance to bacterial clearance rate. Cost efficient and antimicrobial treatment were calculated respectively. Results The 186 strains bacteria were isolated, and the main producing ESBLs bacteria were e. coli bacteria (56.99%) and klebsiella pneumonia (37.63%). The rate of bacterial eradication in these two

  14. 间歇性超声雾化吸入治疗小儿支气管肺炎60例临床护理%Clinical nursing care in the treatment of 60 children patients with infantile bronchopneumonia by using intermittent ultrasonic atomization inhalation therapy

    Institute of Scientific and Technical Information of China (English)



    Objective:To study the nursing methods in the treatment of children patients with infantile bronchopneumonia by using intermittent ultrasonic atomization inhalation therapy.Methods:120 children patients with bronchopneumonia were randomly divided into the study group and the control group (60 cases in each group).The intermittent ultrasonic atomization inhalation therapy was applied in the study group and the continuous atomization inhalation therapy was used in the control group,the patients in both groups were given careful nursing care.The effect of treatment was compared between the two groups.Results:The blood oxygen saturation significantly improved after the treatment in the two groups compared with that before treatment (P <0.01) ;the improvement of blood oxygen saturation was better in the study group than the control group after the treatment (P < 0.05) ;the time of remission of being out of breathe,the disappearing time of moist rale and the length of hospital stay were significantly shorter in the study group than the control group (P < 0.01) ;the incidence of adverse reactions was lower in the study group than the control group (P <0.01).Conclusion:The intermittent ultrasonic atomization inhalation therapy can alleviate inflammatory lesions,dilute sputum,shorten hospitalization time and reduce the incidence of adverse reactions.Careful nursing care is the key to patient's recovery.%目的:探讨间歇性超声雾化吸入治疗支气管肺炎患儿的护理方法.方法:将120例支气管肺炎患儿随机分为研究组和对照组各60例.研究组采用间歇性超声雾化吸入治疗,对照组采用持续性雾化吸入治疗,均给予精心护理.比较两组治疗效果.结果:两组治疗后血氧饱和度较前均有明显改善(P<0.01),研究组治疗后血氧饱和度改善情况优于对照组(P<0.05);研究组憋喘缓解时间、肺部湿罗音消失时间及住院时间均明显少于对照组(P<0.01),不良反应发

  15. Efficacy of ceftiofur and flunixin in the early treatment of bronchopneumonia in weaners. (United States)

    Halloy, D J; Cambier, C; Gustin, P G


    Three groups of five pigs were inoculated intratracheally with Escherichia coli lipopolysaccharides, and 24 hours later with 10 x 10(9) colony-forming units of a non-toxigenic strain of Pasteurella multocida type A; a fourth group was left uninoculated as controls. The three inoculated groups received either no treatment (positive controls), or were treated with 3 mg/kg ceftiofur intramuscularly once a day for five consecutive days, either alone or combined with 2 mg/kg flunixin intramuscularly once a day for three consecutive days. The sustained coughing and hyperthermia recorded in the positive controls disappeared after two days and three days of treatments, respectively, in the treated animals, and the reductions in daily weight gain and changes in breathing pattern observed in the controls were not observed in the treated animals. There were no significant differences between the pigs treated with ceftiofur alone or ceftiofur combined with flunixin. In the positive controls, the number of inflammatory cells in samples of bronchoalveolar lavage fluid continued to increase up to 15 days after inoculation, whereas in the treated animals there were similar increases at six days but the numbers had decreased to baseline levels after 15 days. Similarly, in the treated animals the volume of the lung lesions was significantly less than in the control animals, but the inclusion of flunixin in the treatment regimen had no significant additional effect.

  16. Rapidly vanishing lung pseudotumor in a patient with acute bilateral bronchopneumonia

    Directory of Open Access Journals (Sweden)

    Lazović Biljana


    Full Text Available Introduction. Rapidly vanishing lung pseudotumor (phantom tumor refers to the transient well-demarcated accumulation of pleural fluid in the interlobar pulmonary fissures. Most frequently their appearance is associated with congestive heart failure, but also other disorders like hypoalbuminemia, renal insufficiency or pleuritis. Its rapid disappearance in response to the treatment of the underlying disorder is a classical feature of this clinical entity. Case report. A 47-yearold woman, chronic smoker with symptoms of shortness of breath, orthopnea, chills, cough, weakness and the temperature of 39.2°C was admitted to our hospital. A posteroanterior chest X-ray revealed cardiomegaly with the cardiothoracic ratio of > 0.5, blunting of both costophrenic angles and an adjacent 6 x 5 cm well-defined, rounded opacity in the right interlobar fissure. Transthoracic 2-dimensional echocardiography demonstrated left ventricular hyperthrophy with a systolic ejection fraction of 25% and moderate mitral regurgitation. The patient’s symptoms resolved rapidly after diuresis, and repeated chest X-ray four days later showed that the right lung opacity and pleural effusions had vanished. Conclusion. The presented case underlines the importance of the possibility of vanishing lung tumor in patients with left ventricular failure and a sharp oval lung mass on the chest X-ray. This is the way to avoid incorrect interpretation of this finding causing additional, unnecessary, costly or invasive imaging, interventions and drugs.

  17. [Use of nonspecific agents and vaccination in bronchopneumonia prevention in cattle]. (United States)

    Terziev, V; Planski, B; Encheva, Iu


    A group of 463 calves, kept under one and the same conditions of tending and feeding, were followed up from the fifteenth day after birth up to one year of age, after treatment by subgroups with a hyperimmune antibovine rabbit serum, biomass of chlorella, a tissue preparation of swine embryos, and vaccines against mucosal diseases and infectious bovine rhinotracheitis. The experiment revealed that those of the calves that were treated with a combination of chlorella biomass and a hyperimmune antibovine rabbit serum were most in number (80 per cent) that did not contract and develop diseases. Calves that were individually treated with each single one of these two agents also showed a high percent of intacts --72-73%. Third ranked the subgroup of animals in remaining unaffected with diseases (56 to 60 per cent) that were treated with the MD and IBR vaccines and the swine embryo tissue preparation.

  18. H7N9 live attenuated influenza vaccine is highly immunogenic, prevents virus replication, and protects against severe bronchopneumonia in ferrets

    NARCIS (Netherlands)

    Jonge, de J.; Isakova-Sivak, Irina; Dijken, van Harry; Spijkers, Sanne; Mouthaan, Justin; Klaassen-de Jong, Rineke; Smolonogina, Tatiana; Roholl, Paul; Rudenko, Larisa


    Avian influenza viruses continue to cross the species barrier, and if such viruses become transmissible among humans, it would pose a great threat to public health. Since its emergence in China in 2013, H7N9 has caused considerable morbidity and mortality. In the absence of a universal influenza

  19. Evaluación clínica temprana del tratamiento de neumonías y bronconeumonías en Terapia Intensiva Cardiovascular / Early clinical assessment of pneumonia and bronchopneumonia treatment in a Cardiovascular Intensive Care Unit


    Andrés M. Rodríguez Acosta; Cándido S. Abilio Luciano; Juan C. Cuellar Pérez


    Introducción: Las infecciones nosocomiales son frecuentes. La neumonía nosocomial es la segunda más común entre este tipo de infecciones y es la primera en la Unidad de Terapia Intensiva, donde alcanza una incidencia de 10 a 20 %.Objetivo: Determinar el efecto de la evaluación clínica evolutiva desde 48 - 72 horas de iniciado el tratamiento antimicrobiano.Método: Se realizó una investigación descriptiva, prospectiva de corte longitudinal, en 57 pacientes (muestreo incidental) con diagnóstico ...

  20. A Research and Analysis Paper Focusing on the Timing of Hospital Admittance Based on 8474 Cases of Pediatri Bronchopneumonia Patients%8478例儿科支气管肺炎病人入院时间分析

    Institute of Scientific and Technical Information of China (English)

    麦毅忠; 王小群; 莫金月



  1. 支气管肺炎患儿治疗前后血清hs-CRP、IL-18和IL-1β检测的临床意义%Clinical significance of changes of serum hs-CRP,IL-18 and IL-1β levels in patients with bronchopneumonia

    Institute of Scientific and Technical Information of China (English)

    黄德芳; 刘党英


    目的 探讨支气管肺炎患儿治疗前后血清hs-CRP、IL-18和IL-1β含量变化及意义.方法 应用免疫比浊法和ELIA法对33例支气管肺炎患儿进行了治疗前后血清hs-CRP、IL-18和IL-1β的检测,并与35名正常健康儿作比较.结果 支气管肺炎患儿治疗前后血清hs-CRP、IL-18和IL-1β水平非常显著地高于正常人组(P<0.01)且血清hs-CRP、IL-18和IL-1β水平呈明显正相关(r=0.5084,0.6123,P<0.01).结论 血清hs-CRP、IL-18和IL-1β水平的变化与支气管肺炎的发生和发展有关.

  2. [Incidence of nosocomial respiratory tract diseases in intensive care units]. (United States)

    Papazian, L; Granthil, C


    The incidence of nosocomial bronchopneumonia varies according to authors. Several factors contributes to this diversity. Among them is the type of patients, the severity of disease on admission, the ventilation mode, the criteria of nosocomial bronchopneumonia diagnostic. These considerations should be taken in account by clinician interpreting literature results.

  3. Canine distemper virus infection with secondary Bordetella bronchiseptica pneumonia in dogs


    HEADLEY, Selwyn Arlington; Graça,Dominguita Lühers; Costa,Mateus Matiuzzi da; Vargas,Agueda Castagna de


    Canine distemper virus infection and secondary Bordetella bronchiseptica pneumonia are described in mongrel dogs. Canine distemper was characterised by nonsuppurative demyelinating encephalitis with typical inclusion bodies in astrocytes. B. bronchiseptica was isolated from areas of purulent bronchopneumonia.

  4. Pneumonia due to Haemophilus influenzae (H. aegyptius) biotype 3. (United States)

    Marraro, R V; McCleskey, F K; Mitchell, J L


    Haemophilus influenzae (H. aegyptius) biotype 3 was isolated from eye, nasopharyngeal, and sputum cultures of a 23-month-old male and from sputum and transtracheal aspirate cultures of his 39-year-old mother, both with diffuse bronchopneumonia.

  5. An Investigation of the Pathology and Pathogens Associated with Porcine Respiratory Disease Complex in Denmark

    DEFF Research Database (Denmark)

    Hansen, Mette Sif; Pors, S. E.; Jensen, H. E.;


    Respiratory infections are among the most important diseases of growing pigs. In order to elucidate the multifactorial aetiology of porcine respiratory disease complex (PRDC) in Denmark, lungs from 148 finishing pigs with cranioventral bronchopneumonia (case group) and 60 pigs without lung lesions......), porcine reproductive and respiratory syndrome virus (both European and US type), porcine circovirus type 2 (PCV2), porcine respiratory coronavirus, porcine cytomegalovirus, Mycoplasma hyopneumoniae and Mycoplasma hyorhinis. All cases had cranioventral lobular bronchopneumonia consistent with PRDC...

  6. Association of Mycoplasma ovipneumoniae infection with population-limiting respiratory disease in free-ranging Rocky Mountain bighorn sheep (Ovis canadensis canadensis). (United States)

    Besser, Thomas E; Cassirer, E Frances; Potter, Kathleen A; VanderSchalie, John; Fischer, Allison; Knowles, Donald P; Herndon, David R; Rurangirwa, Fred R; Weiser, Glen C; Srikumaran, Subramaniam


    Bronchopneumonia is a population-limiting disease in bighorn sheep in much of western North America. Previous investigators have isolated diverse bacteria from the lungs of affected sheep, but no single bacterial species is consistently present, even within single epizootics. We obtained high-quality diagnostic specimens from nine pneumonic bighorn sheep in three populations and analyzed the bacterial populations present in bronchoalveolar lavage specimens of seven by using a culture-independent method (16S rRNA gene amplification and clone library analyses). Mycoplasma ovipneumoniae was detected as a predominant member of the pneumonic lung flora in lambs with early lesions of bronchopneumonia. Specific PCR tests then revealed the consistent presence of M. ovipneumoniae in the lungs of pneumonic bighorn sheep in this study, and M. ovipneumoniae was isolated from lung specimens of five of the animals. Retrospective application of M. ovipneumoniae PCR to DNA extracted from archived formalin-fixed, paraffin-embedded lung tissues of historical adult bighorn sheep necropsy specimens supported the association of this agent with bronchopneumonia (16/34 pneumonic versus 0/17 nonpneumonic sheep were PCR positive [P M. ovipneumoniae antibody-positive animals and the occurrence of current or recent historical bronchopneumonia problems (seropositive animals detected in 9/9 versus 0/9 pneumonic and nonpneumonic populations, respectively [P M. ovipneumoniae is strongly associated with bronchopneumonia in free-ranging bighorn sheep and is a candidate primary etiologic agent for this disease.

  7. Association of Mycoplasma ovipneumoniae Infection with Population-Limiting Respiratory Disease in Free-Ranging Rocky Mountain Bighorn Sheep (Ovis canadensis canadensis)▿ (United States)

    Besser, Thomas E.; Cassirer, E. Frances; Potter, Kathleen A.; VanderSchalie, John; Fischer, Allison; Knowles, Donald P.; Herndon, David R.; Rurangirwa, Fred R.; Weiser, Glen C.; Srikumaran, Subramaniam


    Bronchopneumonia is a population-limiting disease in bighorn sheep in much of western North America. Previous investigators have isolated diverse bacteria from the lungs of affected sheep, but no single bacterial species is consistently present, even within single epizootics. We obtained high-quality diagnostic specimens from nine pneumonic bighorn sheep in three populations and analyzed the bacterial populations present in bronchoalveolar lavage specimens of seven by using a culture-independent method (16S rRNA gene amplification and clone library analyses). Mycoplasma ovipneumoniae was detected as a predominant member of the pneumonic lung flora in lambs with early lesions of bronchopneumonia. Specific PCR tests then revealed the consistent presence of M. ovipneumoniae in the lungs of pneumonic bighorn sheep in this study, and M. ovipneumoniae was isolated from lung specimens of five of the animals. Retrospective application of M. ovipneumoniae PCR to DNA extracted from archived formalin-fixed, paraffin-embedded lung tissues of historical adult bighorn sheep necropsy specimens supported the association of this agent with bronchopneumonia (16/34 pneumonic versus 0/17 nonpneumonic sheep were PCR positive [P M. ovipneumoniae antibody-positive animals and the occurrence of current or recent historical bronchopneumonia problems (seropositive animals detected in 9/9 versus 0/9 pneumonic and nonpneumonic populations, respectively [P M. ovipneumoniae is strongly associated with bronchopneumonia in free-ranging bighorn sheep and is a candidate primary etiologic agent for this disease. PMID:18057131

  8. Chest computed tomography of late invasive aspergillosis after allogeneic hematopoietic stem cell transplantation. (United States)

    Kojima, Rie; Tateishi, Ukihide; Kami, Masahiro; Murashige, Naoko; Nannya, Yasuhito; Kusumi, Eiji; Sakai, Miwa; Tanaka, Yuji; Kanda, Yoshinobu; Mori, Shin-Ichiro; Chiba, Shigeru; Kusumoto, Masahiko; Miyakoshi, Shigesaburo; Hirai, Hisamaru; Taniguchi, Shuichi; Sakamaki, Hisashi; Takaue, Yoichi


    Computed tomography (CT) is a powerful diagnostic tool for invasive aspergillosis (IA) after allogeneic stem cell transplantation (allo-SCT); however, little information is available concerning CT findings of late IA after allo-SCT. To characterize CT findings of late IA, we retrospectively examined medical records and high-resolution CT findings of 27 allo-SCT recipients with late IA. Either acute or chronic GVHD was diagnosed in 24 patients. All 27 patients were given corticosteroids at IA diagnosis. High-resolution CT findings included halo (n=12), centrilobular nodules (n=12), ill-defined consolidation (n=13), ground-glass attenuation (n=8), pleural effusion (n=7), pleural-based consolidation (n=4), and cavitation (n=4). CT findings showing centrilobular nodules and either halo or cavitation were classified into bronchopneumonia type and angioinvasive type, respectively. Angioinvasive-type, bronchopneumonia-type, and combination-type IA were diagnosed in 11, 8, and 4 patients, respectively. CT findings were nonspecific in the other 4 patients. One bronchopneumonia-type case and 2 angioinvasive-type IA cases were subsequently diagnosed as combination type. Although there were no significant differences in patient characteristics between the 2 types of IA, bronchopneumonia-type IA had a poorer prognosis than angioinvasive IA ( P=.022). Halo is a useful diagnostic marker in late IA as well as early IA, and late IA frequently manifests as bronchopneumonia.

  9. [Natural and experimental infections of lambs with Mycoplasma ovipneumoniae]. (United States)

    Bocklisch, H; Pfützner, H; Zepezauer, V


    Mycoplasma (M.) ovipneumoniae was isolated pure or mixed with bacteria from 47 lungs of lambs of 14 in 22 tested flocks. M. ovipneumoniae was obtained as pure culture in cases of mild bronchopneumonia. Experimental intratracheal or intranasal infection caused several days of rising body temperature above 39.7 degrees C. Nasal discharge, coughing, and dyspnea did not occur. M. ovipneumoniae was successfully re-isolated from nasal swabs, beginning 2 d from infection. Lobular catarrhal bronchopneumonia was established by postmortem examinations, 10-14 d from infection, and M. ovipneumoniae was re-isolated from the lungs. Histological patterns of lungs were characterised by interstitial cell reactions.

  10. Pneumonia and gastritis in a cat caused by feline herpesvirus-1


    McGregor, Glenna F.; Sheehan, Karen; Simko, Elemir


    We report a case of fatal respiratory and gastric herpesvirus infection in a vaccinated, adult cat with no known immunosuppression or debilitation. The disease was characterized by severe necrotizing bronchopneumonia, fibrinonecrotic laryngotracheitis, and multifocal necrotizing gastritis associated with eosinophilic intranuclear inclusion bodies and a large amount of feline herpesvirus-1 antigen detected with immunohistochemistry.

  11. Pneumonia and gastritis in a cat caused by feline herpesvirus-1. (United States)

    McGregor, Glenna F; Sheehan, Karen; Simko, Elemir


    We report a case of fatal respiratory and gastric herpesvirus infection in a vaccinated, adult cat with no known immunosuppression or debilitation. The disease was characterized by severe necrotizing bronchopneumonia, fibrinonecrotic laryngotracheitis, and multifocal necrotizing gastritis associated with eosinophilic intranuclear inclusion bodies and a large amount of feline herpesvirus-1 antigen detected with immunohistochemistry.

  12. Multidrug-resistant endemic clonal strain of Candida auris in India

    NARCIS (Netherlands)

    Chowdhary, A.; Kumar, V.; Sharma, C.; Prakash, A.; Agarwal, K.; Babu, R.; Dinesh, K.R.; Karim, S.; Singh, S.K.; Hagen, F.; Meis, J.F.G.M.


    Candida auris is a recently described rare agent of fungemia. It is notable for its antifungal resistance. A total of 15 C. auris isolates, originating from seven cases of fungemia, three cases of diabetic gangrenous foot, and one case of bronchopneumonia from a tertiary care hospital in south India

  13. Bordetella bronchiseptica and fatal pneumonia of dogs and cats (United States)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  14. Cilia-associated bacteria in fatal Bordetella bronchiseptica pneumonia of dogs and cats (United States)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  15. Fluorescence-Based Reporter for Gauging Cyclic Di-GMP Levels in Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Rybtke, Morten T.; Borlee, Bradley R.; Murakami, Keiji


    The increased tolerance toward the host immune system and antibiotics displayed by biofilm-forming Pseudomonas aeruginosa and other bacteria in chronic infections such as cystic fibrosis bronchopneumonia is of major concern. Targeting of biofilm formation is believed to be a key aspect in the dev...


    Directory of Open Access Journals (Sweden)

    M. Nozadi


    Full Text Available Since hospitals are an important and integral part of the overall health delivery system, this study was carried out to measure the effectiveness of this institution within the system. The records of 633 hospitalized patients in the pediatrics ward of Ghaem Hospital in Mashhad during 1357 (21 March 1978-20 March 1979 has been consulted. More than half of the patients were hospitalized with the following diagnoses: Bronchopneumonia, Gastroentritis, Septicemia, and Malnutrition. Bronchopneumonia peaked in winter, whereas Gastroentritis and Malnutrition peaked in summer. Most of the hospitalized patients were male and the malnutrition was limited to the pre-school children of 1-6 years of age. The importance of these findings in development and utilization of the health delivery system has been discussed and considering the preventable nature of the above mentioned diseases, development and expansion of primary health care activities has been stressed.

  17. Atypical severe combined immunodeficiency caused by a novel homozygous mutation in Rag1 gene in a girl who presented with pyoderma gangrenosum: a case report and literature review. (United States)

    Patiroglu, Turkan; Akar, H Haluk; Gilmour, Kimberly; Ozdemir, M Akif; Bibi, Shahnaz; Henriquez, Frances; Burns, Siobhan O; Unal, Ekrem


    Severe combined immunodeficiency (SCID) is a heterogeneous group of inherited defects involving the development of T- and/or B-lymphocytes. We report a female with atypical severe combined immunodeficiency caused by a novel homozygous mutation at cDNA position 2290 (c.2290C > T) in exon 2 of the RAG1 gene. The patient presented with bronchopneumonia, pyoderma gangrenosum (PG), pancytopenia and splenomegaly. She presented to us with pancytopenia and splenomegaly at the age of 11. Her condition was complicated by PG on left lower ankle at the age of 12. She experienced bronchopneumonia at the age of 15. She was diagnosed with RAG1 deficiency at the age of 16. Her immunological presentation included leucopenia and diminished number of B cells.

  18. [Morphologic analysis of a case of Sheehan's postpartal hypophyseal necrosis]. (United States)

    Jovanovic, R; Stevanović, G


    The post-mortem finding of a 39-year-old woman with the Sheehan postpartal necrosis of the hypophysis is described. This was the only such case of 16,580 obductions of women in the period from 1961 to 1976. The cause of death was cerebral encephalomalacia and non-specific bronchopneumonia. The death occurred five years after the last delivery and almost three years after the established clinical diagnosis.

  19. Epizootic pneumonia of bighorn sheep following experimental exposure to Mycoplasma ovipneumoniae.

    Directory of Open Access Journals (Sweden)

    Thomas E Besser

    Full Text Available Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis. The cause of this disease has been a subject of debate. Leukotoxin expressing Mannheimia haemolytica and Bibersteinia trehalosi produce acute pneumonia after experimental challenge but are infrequently isolated from animals in natural outbreaks. Mycoplasma ovipneumoniae, epidemiologically implicated in naturally occurring outbreaks, has received little experimental evaluation as a primary agent of bighorn sheep pneumonia.In two experiments, bighorn sheep housed in multiple pens 7.6 to 12 m apart were exposed to M. ovipneumoniae by introduction of a single infected or challenged animal to a single pen. Respiratory disease was monitored by observation of clinical signs and confirmed by necropsy. Bacterial involvement in the pneumonic lungs was evaluated by conventional aerobic bacteriology and by culture-independent methods. In both experiments the challenge strain of M. ovipneumoniae was transmitted to all animals both within and between pens and all infected bighorn sheep developed bronchopneumonia. In six bighorn sheep in which the disease was allowed to run its course, three died with bronchopneumonia 34, 65, and 109 days after M. ovipneumoniae introduction. Diverse bacterial populations, predominantly including multiple obligate anaerobic species, were present in pneumonic lung tissues at necropsy.Exposure to a single M. ovipneumoniae infected animal resulted in transmission of infection to all bighorn sheep both within the pen and in adjacent pens, and all infected sheep developed bronchopneumonia. The epidemiologic, pathologic and microbiologic findings in these experimental animals resembled those seen in naturally occurring pneumonia outbreaks in free ranging bighorn sheep.

  20. In Vitro Potential of Equine DEFA1 and eCATH1 as Alternative Antimicrobial Drugs in Rhodococcosis Treatment


    Schlusselhuber, Margot; Jung, Sascha; Bruhn, Oliver; Goux, Didier; Leippe, Matthias; Leclercq, Roland; Laugier, Claire; Grötzinger, Joachim; Cauchard, Julien


    Rhodococcus equi, the causal agent of rhodococcosis, is a severe pathogen of foals but also of immunodeficient humans, causing bronchopneumonia. The pathogen is often found together with Klebsiella pneumoniae or Streptococcus zooepidemicus in foals. Of great concern is the fact that some R. equi strains are already resistant to commonly used antibiotics. In the present study, we evaluated the in vitro potential of two equine antimicrobial peptides (AMPs), eCATH1 and DEFA1, as new drugs agains...

  1. Diagnosis of unilateral pulmonary arterial agenesis using scintiangiography - a case report -

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Kim, Choon Yul; Shinn, Kyung Sub; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)


    A 7-year-old boy presented with productive cough and mild dyspne a. He had a history of intermittant attacks of bronchopneumonia, but otherwise he was healthy. He had a small right lung on chest roentgenograms. The diagnosis of developmental hypoplasia of the right lung due to congenital absence of the right pulmonary artery was made by radionuclide angiocardiography and subsequently confirmed by cardiac catheterization and angiography.

  2. Measles, Mumps, and Rubella - Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Vol. 47/No. RR-8. (United States)


    from the inner ear after sudden deafness. Br Med J 1979;1:14. 45. Siegel MS, Fuerst HT, Peress NS. Comparative fetal mortality in maternal virus...diarrhea, middle ear infection, or bronchopneumonia. Encephalitis occurs in approximately one of every 1,000 reported cases; survivors of this complication...affected infants (2-5). Birth de- fects, with no definable pattern of malformation , have been reported among infants born to women infected with

  3. The Most Common Detected Bacteria in Sputum of Patients with Community Acquired Pneumonia (CAP) Treated In Hospital (United States)

    Cukic, Vesna; Hadzic, Armin


    Introduction: Community acquired pneumonia (CAP) is the most common infective pulmonary disease. Objective: To show the most common detected bacteria in bacterial culture of sputum in patients with CAP hospitalized in Clinic for Pulmonary Diseases and TB “Podhrastovi” in four-year period: from 2012 to 2015. Material and methods: This is the retrospective analysis. Each patient gave sputum 3 days in a row when admitted to hospital. Sputum has been examined: bacterial culture with antibiotics sensitivity, Gram stain, Mycobacterium tuberculosis; in cases with high temperature blood cultures were done; when we were suspicious about bronchial carcinoma bronchoscopy with BAL (bronchoalveolar lavage) was done. We show analyzed patients according to age, sex, whether they had pneumonia or bronchopneumonia, bacteria isolated in sputum and in BAL. Results: 360 patients with CAP were treated in four-year period (247 males and 113 females). 167 or 43, 39 % had pneumonia (119 males and 48 females). Number of males was significantly bigger (χ2 = 30,186; p<0,001). 193 or 53, 61 % had bronchopneumonia (128 males and 65 females). Number of males was significantly bigger (χ2 = 20,556; p<0,001). Number of patients with negative bacterial culture of sputum (131–78, 44%) was significantly bigger than number of patients with positive culture (36–21, 56%) (χ2 = 50,042; p<0,001) in pneumonia. Number of patients with negative bacterial culture of sputum (154- 79, 79%) was significantly bigger than number of patients with positive culture (39- 20, 21%) (χ2 = 68,523; p<0,001) in bronchopneumonia. Streptococcus pneumoniae was significantly most common detected bacterium compared with the number of other isolated bacteria; in pneumonia (χ2 =33,222; p<0,001) and in bronchopneumonia (χ2 =51,231; p<0,001). Conclusion: It is very important to detect the bacterial cause of CAP to administrate the targeted antibiotic therapy. PMID:27994296

  4. Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia

    Directory of Open Access Journals (Sweden)

    Ibrahim MI


    Full Text Available Background: Therapeutic drug monitoring (TDM makes use of serum drug concentrations as an adjunct to decision-making. Preliminary data in our hospital showed that approximately one-fifth of all drugs monitored by TDM service were gentamicin. Objective: In this study, we evaluated the costs associated with providing the service in patients with bronchopneumonia and treated with gentamicin. Methods: We retrospectively collected data from medical records of patients admitted to the Hospital Universiti Sains Malaysia over a 5-year period. These patients were diagnosed with bronchopneumonia and were on gentamicin as part of their treatment. Five hospitalisation costs were calculated; (i cost of laboratory and clinical investigations, (ii cost associated with each gentamicin dose, (iii fixed and operating costs of TDM service, (iv cost of providing medical care, and (v cost of hospital stay during gentamicin treatment. Results: There were 1920 patients admitted with bronchopneumonia of which 67 (3.5% had TDM service for gentamicin. Seventy-three percent (49/67 patients were eligible for final analysis. The duration of gentamicin therapy ranged from 3 to 15 days. The cost of providing one gentamicin assay was MYR25, and the average cost of TDM service for each patient was MYR104. The average total hospitalisation cost during gentamicin treatment for each patient was MYR442 (1EUR approx. MYR4.02. Conclusion: Based on the hospital perspective, in patients with bronchopneumonia and treated with gentamicin, the provision of TDM service contributes to less than 25% of the total cost of hospitalization.

  5. Forensic intoxication with clobazam: HPLC/DAD/MSD analysis



    Clobazam (Castillium®, Urbanil®), a benzodiazepine often used as an anxiolytic and in the treatment of epilepsy, is considered a relatively safe drug. The authors present a fatal case with a 49-year-old female, found dead at home. She had been undergoing psychiatric treatment and was a chronic alcoholic. The autopsy findings were unremarkable, except for multivisceral congestion, steatosis and a small piece of a plastic blister pack in the stomach. Bronchopneumonia, bronchitis and bronchiolit...

  6. Pneumonia in slaughtered sheep in south-western Iran: pathological characteristics and aerobic bacterial aetiology

    Directory of Open Access Journals (Sweden)

    Shahrzad Azizi


    Full Text Available In this study, the lungs of 1,000 sheep carcasses were subjected to gross examination and those suspected to be infected with pneumonia were studied at histopathological level as well as examined for presence of bacteria. Pneumonia was detected in 42 (4.2% carcasses. Based on histopathological lesions, 45.24% were affected with suppurative bronchopneumonia, 20.93% with interstitial pneumonia, 11.9% bronchointerstitial pneumonia, 7.14% with fibrinous bronchopneumonia and 2.38% with embolic pneumonia. In addition, 11.9% of the lungs showed lung abscesses and 2.33% were affected with pleuritis without involving pulmonary parenchyma. Bacteriological examination revealed presence of ovine pathogens, such as Pasteurella multocida (24.53%, Staphylococcus aureus (20.75%, Klebsiella pneumoniae (15.09%, Corynebacterium pseudotuberculosis (7.55% and Actinomyces pyogenes (1.89%. The most common form of pneumonia was suppurative bronchopneumonia with moderate amounts of fibrin deposits on the pleural surface and inside the bronchioles and alveoli.

  7. Endogenous lipoid pneumonia in a cachectic patient after brain injury. (United States)

    Zhang, Ji; Mu, Jiao; Lin, Wei; Dong, Hongmei


    Endogenous lipoid pneumonia (EnLP) is an uncommon non-life-threatening inflammatory lung disease that usually occurs in patients with conditions such as lung cancers, primary sclerosing cholangitis, and undifferentiated connective tissue disease. Here we report a case of EnLP in a paralytic and cachectic patient with bronchopneumonia after brain injury. A 40-year-old man experienced a severe brain injury in an automobile accident. He was treated for 1 month and his status plateaued. However, he became paralyzed and developed cachexia and ultimately died 145 days after the accident. Macroscopically, multifocal yellowish firm nodules were visible on scattered gross lesions throughout the lungs. Histologically, many foam cells had accumulated within the alveoli and alveolar walls accompanied by a surrounding interstitial infiltration of lymphocytes. The findings were in accordance with a diagnosis of EnLP. Bronchopneumonia was also noted. To our knowledge, there have been few reports of EnLP associated with bronchopneumonia and cachexia after brain injury. This uncommon pathogenesis should be well recognized by clinicians and forensic pathologists. The case reported here should prompt medical staff to increase the nutritional status and fight pulmonary infections in patients with brain injury to prevent the development of EnLP.

  8. Fatal diquat intoxication

    Directory of Open Access Journals (Sweden)

    Jović-Stošić Jasmina


    Full Text Available Background. Since the introduction of diquat in agriculture practice in 1960's, about 40 cases of poisoning have been described in detail in medical literature. Case report. We presented two cases. A case one, a 35-year-old, previously healthy, woman ingested 14% diquat solution. The poisoning had fulminant course, consisted of severe stomachache, vomiting, cardiocirculatory shock, respiratory failure and cardiac arrest 20 hours post-ingestion. Autopsy revealed myocardial infarction, bronchopneumonia and incipient renal damage. A case two, a 64-year-old man developed severe gastroenteritis, corrosive lesions of mucosal surfaces, acute renal injury, arrhythmias, brain stem infarction and bronchopneumonia. The diagnosis of diquat poisoning was made retrospectively upon the clinical picture and identification of pesticides he had been exposed to. The patient died 18 days post-exposure. The most prominent findings on autopsy were pontine hemorrhage and infarction, bronchopneumonia, left ventricle papillary muscle infarction and renal tubular damage. Conclusion. Cardiocirculatory disturbances led to fatal complications, the heart and brain infarction. We pointed out the heart as one of the most severely affected organs in diquat poisoning.

  9. [A scanning electron microscope observation of Dictyocaulus filaria.]. (United States)

    Yildiz, Kader; Cavuşoğlu, Kültiğin


    In this study, D. filaria causing parasitic bronchopneumonia in sheep was observed using a scanning electron microscope. This parasite belongs to the Trichostrongyloidea super family. The oral opening of D. filaria was observed to be small and circular in shape. Lips were not evident. Any difference between anterior ends of male and female parasites was not observed in present study. In the female parasite, the anus was seen as a fissure in shape. The post anal papilla was seen near the posterior end of the female. Spicula and cloacae of male parasites were observed.


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    Gh.- R. Walizadeh


    Full Text Available Autopsy findings in 138 newborn infants which died in a university nursery during 3 years are reviewed and discussed. 80 per cent were premature and small- for- date newborns of up to 2500 g birth weight. Most of these cases showed in addition to general prematurely signs, respiratory tract diseases such as atelectasia, amniotic fluid aspiration and hyaline membrane disease. The full term infants died mostly of malformations. In post neonatal period the cause of death was almost entirely infections such as bronchopneumonia, gastroenteritis and septicemia.

  11. Pathology of experimental infection by Pasteurella multocida serotype A: 1 in buffalo calves. (United States)

    Praveena, P E; Periasamy, S; Kumar, A A; Singh, N


    Pasteurella multocida serotype A:3 has been mostly implicated in pneumonic pasteurellosis in ruminants. In contrast, our previous studies have reported that both serotypes A:1 and A:3 were responsible for respiratory diseases in cattle and buffaloes. However, the pathology and pathogenesis of P. multocida serotype A:1 (Pm A:1) infection have not been studied in ruminants. In the present study, 12- to 15-week-old buffalo calves (Bubalus bubalis) infected by Pm A:1 had fibrinous and suppurative bronchopneumonia with focal areas of coagulation necrosis typical of pneumonic pasteurellosis. For the first time, this study reports the lung pathology and pathogenecity of Pm A:1 infection in calves.

  12. Characterization and time course of pulmonary lesions in calves after intratracheal infection with Pasteurella multocida A:3. (United States)

    Dagleish, M P; Finlayson, J; Bayne, C; MacDonald, S; Sales, J; Hodgson, J C


    Pasteurella multocida A:3 is a common cause of suppurative bronchopneumonia in calves and results in significant production losses and mortality. Here we describe the lesions in three calves at each of four time points (1 day and 4, 7 and 10 days) after experimental intratracheal infection with approximately 1x10(9) colony-forming units of P. multocida A:3 Moredun Research Institute (MRI isolate 671/90). Equivalent age- and time-matched sham-dosed negative control animals were also studied. Infected calves developed significantly elevated mean rectal temperatures (Pmultocida A:3 and provides the foundations for further investigation of the pathogenesis of this disease in cattle.

  13. [Death in the bathtub--rectal drug administration]. (United States)

    Musshoff, F; Dettmeyer, R; Madea, B


    A young nurse was found dead in a bathtub. An autopsy revealed the following results: pulmonary emphysema, severe edema of both lungs, transudation in both pleural cavities. Conspicuous were skin sticks of a white wax material. In chemical-toxicological analysis diazepam, tetrazepam and phenobarbital were detected in this material. After anal-rectal and additionally oral ingestion the following blood concentrations were determined: BAC 0.03/1000; diazepam 500 ng/ml; nordiazepam 65 ng/ml; tetrazepam 180 ng/ml; phenobarbital 9.4 mg/l. In connection with this drug effects an acute, multifocal, suppurating bronchopneumonia in both lungs was revealed as the cause of death.

  14. Non-typeable Haemophilus influenzae purulent pericarditis in a child with cystic fibrosis. (United States)

    Downes, Kevin J; Abulebda, Kamal; Siracusa, Christopher; Moore, Ryan; Staat, Mary A; Poynter, Sue E


    Early airway colonization and infection with Haemophilus influenzae in children with cystic fibrosis (CF) is common. Although the pathogenicity of non-typeable H. influenzae (NTHi) in patients with CF is controversial, this organism can cause both upper and lower respiratory tract infections. Extra-pulmonary disease, however, is rare. Purulent pericarditis is a suppurative complication of bacterial infection of the pericardial space that can arise as a result of direct extension from an adjacent infection. We describe a case of purulent pericarditis due to NTHi in a young child with CF that developed as a complication of inadequately treated bronchopneumonia.

  15. Human transmissible spongiform encephalopathy: Case report

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    Duque Velásquez, Camilo


    Full Text Available We report the case of a 64 year-old woman with motor and cognitive deterioration that progressed rapidly during eight months. She was unsuccessfully treated with quinacrine, and died in a terminal status, by septic shock secondary to bronchopneumonia by broncho-aspiration. The brain was donated for research and the histopathological analysis showed spongiform changes, astrogliosis and prion protein (PrPRes deposits, confirmed by Western blot (WB. These features are considered characteristic of prion diseases, which are uncommon in Colombia. We highlight that its diagnosis was made for the first time in this country by the simultaneous use of immunohistochemistry and Western blot.

  16. Immunoglobulin concentration in blood serum of postcolostral calves: Ratio between immunoglobulin level and appearance of enzootic pneumonia

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    Jonić Branko


    Full Text Available The timely supply of newborn calves with optimal quantities of colostrum has a key role in the process of immune protection in the early phase of their lives. Passively acquired antibodies can protect the digestive organs from infection caused by E.coli bacteria, and it seems also from the appearance of diseases of the respiratory tract. These examinations were performed on a cattle farm where bronchopneumonia was one of the most significant health problems, and a group of 39 calves were selected for the investigations. The calves were fed with their mothers’ colostrum after birth, and then with collective milk. Immunoglobulin concentration was determined in blood samples taken during the postcolostral period, with the method using zinc-sulphate. At the age of 40 days, the calves were administered a polyvalent inactivated vaccine, and revaccinated 20 days after that (Vibak, Veterinary Department Subotica. In 74.34% calves, the immunoglobulin G concentration ranged from 26 to 40 g/l. In 25.66% calves, the immunoglobulin concentration was lower, from 8 to 25 g/l. The calves found to have a lower concentration of immunoglobulin in blood contracted bronchopneumonia more frequently, and the outcome of the disease in some cases was mortality, even.

  17. Pasteurella multocida type A as the primary agent of pneumonia and septicaemia in pigs

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    João X. de Oliveira Filho


    Full Text Available Abstract: In order to understand better the pathological aspects and spread of Pasteurella multocida type A as the primary cause of pneumonia in pigs, was made an experiment with intranasal inoculation of different concentrations of inocula [Group (G1: 108 Colony Forming Units (CFU/ml; G2: 107 CFU/ml; G3: 106 CFU/ml and G4: 105 CFU/ml], using two pigs per group. The pigs were obtained from a high health status herd. Pigs were monitored clinically for 4 days and subsequently necropsied. All pigs had clinical signs and lesions associated with respiratory disease. Dyspnoea and hyperthermia were the main clinical signs observed. Suppurative cranioventral bronchopneumonia, in some cases associated with necrosuppurative pleuropneumonia, fibrinous pericarditis and pleuritic, were the most frequent types of lesion found. The disease evolved with septicaemia, characterized by septic infarctions in the liver and spleen, with the detection of P. multocida type A. In this study, P. multocida type A strain #11246 was the primary agent of fibrinous pleuritis and suppurative cranioventral bronchopneumonia, pericarditis and septicaemia in the pigs. All concentrations of inoculum used (105-108 CFU/ml were able to produce clinical and pathological changes of pneumonia, pleuritis, pericarditis and septicemia in challenged animals.

  18. Lower respiratory tract infection in cynomolgus macaques (Macaca fascicularis) infected with group A Streptococcus. (United States)

    Olsen, Randall J; Ashraf, Madiha; Gonulal, Vedia E; Ayeras, Ara A; Cantu, Concepcion; Shea, Patrick R; Carroll, Ronan K; Humbird, Tammy; Greaver, Jamieson L; Swain, Jody L; Chang, Ellen; Ragasa, Willie; Jenkins, Leslie; Lally, Kevin P; Blasdel, Terry; Cagle, Philip; Musser, James M


    Group A Streptococcus (GAS), a human-specific pathogen, is best known for causing pharyngitis ("strep-throat") and necrotizing fasciitis ("flesh-eating disease"). However, the organism is also an uncommon but important cause of community-acquired bronchopneumonia, an infection with an exceptionally high mortality rate. Inasmuch as little is known about the molecular pathogenesis of GAS lower respiratory tract infection, we sought to develop a relevant human infection model. Nine cynomolgus macaques were infected by intra-bronchial instillation of either sterile saline or GAS (10(5) or 10(7) CFU). Animals were continuously monitored and sacrificed at five days post-inoculation. Serial bronchial alveolar lavage specimens and tissues collected at necropsy were used for histologic and immunohistochemical examination, quantitative microbial culture, lung and blood biomarker analysis, and in vivo GAS gene expression studies. The lower respiratory tract disease observed in cynomolgus macaques mimicked the clinical and pathological features of severe GAS bronchopneumonia in humans. This new monkey model will be useful for testing hypotheses bearing on the molecular pathogenesis of GAS in the lower respiratory tract.

  19. Pneumonia and bacteremia in a golden-headed lion tamarin (Leontopithecus chrysomelas) caused by Klebsiella pneumoniae subsp. pneumoniae during a translocation program of free-ranging animals in Brazil. (United States)

    Bueno, Marina G; Iovine, Renata O; Torres, Luciana N; Catão-Dias, José L; Pissinatti, Alcides; Kierulff, Maria C M; Carvalho, Vania M


    Klebsiella pneumoniae is an important emerging pathogen in humans, particularly the invasive hypermucoviscosity (HMV) phenotype. In addition, the organism is an important public health concern because of nosocomial infections and antimicrobial resistance. Nonhuman primates in captivity are susceptible to Klebsiella, particularly when a stress factor is involved. Infections vary depending on the species but can cause significant morbidity and mortality in these animals. The objective of this study was to describe a case of bronchopneumonia and bacteremia caused by Klebsiella pneumoniae in a free-ranging golden-headed lion tamarin (Leontopithecus chrysomelas) caught and maintained in quarantine during a translocation program for conservation purposes. An adult male, that had showed emaciation and apathy, was clinically examined and, despite being provided supportive therapy, died 2 days after onset of clinical signs. At postmortem examination, generalized bilateral pneumonia and pericarditis were observed. Tissue samples were fixed in 10% formalin for histology, and pulmonary tissues and cardiac blood were collected for microbiologic diagnostic procedures. Bacteria that were shown to be HMV K. pneumoniae subsp. pneumoniae strains were isolated from the pulmonary fluids and cardiac blood in pure cultures. Severe bronchopneumonia was the main pathological finding. The consequences of the confirmed presence of the HMV phenotype of K. pneumoniae subsp. pneumoniae in this wildlife species for human, animal, and ecosystem health should be determined. These results demonstrate the importance of quarantine and potential pathogen screening during wildlife translocation procedures.

  20. Equine pulmonary aspergillosis with encephalitic, myocardial, and renal dissemination. (United States)

    Headley, Selwyn Arlington; de Carvalho, Pedro Henrique; Cunha Filho, Luiz Fernando C; Yamamura, Aline Artioli Machado; Okano, Werner


    The cause of the death of a 16-month-old Brasileiro-de-Hipismo filly and a 3-year-old male Paint Horse with clinical manifestations of anemia and apathy from southern Brazil was investigated. These horses were maintained at the same stable; received hay as part of their diet and were submitted for routine necropsy evaluations. Significant gross findings included several nodules randomly distributed throughout the pulmonary lobes of both horses, and the kidneys, myocardium, and the frontal lobes of the cerebrum of the filly. Histopathological evaluation revealed pyogranulomatous bronchopneumonia in both horses; granulomatous interstitial nephritis, myocarditis, and encephalitis were observed in the filly. All lesions contained vasculitis and thrombosis associated with myriads of intralesional, branching, septate fungi consistent with Aspergillus spp.; intralesional fungi were more easily identified by the Grocott methenamine silver stain. Mycological culture of fresh pulmonary sections from both horses and the brain of the filly revealed pure growths of A. fumigatus. These findings confirmed the participation of A. fumigatus in the etiopathogenesis of the lesions observed in the lungs of both horses, and the cerebrum, myocardium and kidneys of the filly and might represent the first description of A. fumigatus-induced encephalitis in horses. Additionally, we believe that infection occurred during the ingestion of contaminated hay or by inhalation of spores within contaminated bedding that resulted in transient nasal mycosis, which progressed to pyogranulomatous bronchopneumonia in both horses with embolic encephalitic, myocardial, and renal dissemination of A. fumigatus occurring only in the filly.

  1. The Effect of Exclusive Breastfeeding on Hospital Stay and Morbidity due to Various Diseases in Infants under 6 Months of Age: A Prospective Observational Study. (United States)

    Kaur, Amarpreet; Singh, Karnail; Pannu, M S; Singh, Palwinder; Sehgal, Neeraj; Kaur, Rupinderjeet


    Background. Mother's milk is the best for the babies. Protective and preventive role of breast milk was evaluated in this study by assessing the relation of type of feeding and duration of hospital stay or morbidity. Methods. This prospective study was conducted in a tertiary care hospital and 232 infants in the age group of 14 weeks to 6 months formed the sample. There are two groups of infants, that is, one for breastfed and one for top fed infants. Statistical analysis was done and results were calculated up to 95% to 99% level of significance to find effect of feeding pattern on hospital stay due to various diseases and morbidity. Results. Prolonged hospital stay, that is, >7 days, was lesser in breastfed infants and results were statistically significant in case of gastroenteritis (p value < 0.001), bronchopneumonia (p value = 0.0012), bronchiolitis (p value = 0.005), otitis media (p value = 0.003), and skin diseases (p value = 0.047). Lesser morbidity was seen in breastfed infants with gastroenteritis (p value 0.0414), bronchopneumonia (p value 0.03705), bronchiolitis (p value 0.036706), meningitis (p value 0.043), and septicemia (p value 0.04). Conclusions. Breastfed infants have shorter hospital stay and lesser morbidity in regard to various diseases as compared to top fed infants.

  2. Inclusões intracitoplasmáticas hialinas na medular da adrenal de bovinos

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    L.P Mesquita


    Full Text Available Cytoplasmic inclusion bodies in adrenal medullary chromaffin cells have been described in various species including humans. These inclusions are believed to be related to certain infectious, toxic and neurodegenerative diseases. No reports concerning such adrenal inclusions have been described in bovines. Adrenal glands from twenty bovines were evaluated in a retrospective study. Seven of these exhibited inclusions - three cases of rabies, two cases of chronic suppurative bronchopneumonia, one case of chronic suppurative peritonitis, and one case of gangrenous mastitis. The inclusions were present in higher numbers especially in cases of rabies and also in one case of chronic suppurative bronchopneumonia. The inclusions were intracytoplasmic, eosinophilic, rounded, single or multiple, of various sizes, strongly stained by PAS and were present in higher numbers in the external layer of the adrenal medulla. The inclusions were negative when subjected to immunohistochemistry for detection of viral antigens in the cases of rabies. Although inclusion bodies were present in adrenal glands devoid of other histological alterations, they were more abundant in cases in which the adrenal gland had other alterations. The correlation between certain diseases and the development of inclusion bodies is not known, which highlights the importance of further studies on these inclusions in adrenal glands of bovines.

  3. In-hospital Mortality due to Respiratory Diseases in the Provincial Hospital of Cienfuegos. 2010-2014

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    Liuva Leyva Rodríguez


    Full Text Available Background: in-hospital mortality is a health indicator commonly used as a measure of quality of care. Respiratory diseases are a major cause of deaths in hospitals. Objective: to describe mortality from respiratory diseases at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos. Methods: a descriptive study of all patients over 18 years old who died from respiratory diseases in the hospital of Cienfuegos from 2010 to 2014 was conducted. The variables analyzed were: age, sex, length of stay, services where the patients died, cause of death, and associated diseases. Results: there was an increase in patients admitted for respiratory diseases and a higher mortality from these diseases (36.2%. Males (54.7%, patients over 75 years (62.5%, and those admitted to internal medicine wards (39.2% predominated. Forty eight point eight percent died within the first 72 hours. The most common respiratory conditions were: pneumonia/bronchopneumonia, chronic obstructive pulmonary disease, and lung cancer, respectively. Sixty three point four percent of the cases developed associated diseases, mainly cardiovascular conditions (26.6%. Conclusions: respiratory diseases are responsible for high in-hospital mortality; the most common causes are pneumonia/bronchopneumonia, mainly in males and in patients older than 75 years.

  4. Computed tomography of the thorax in calves from birth to 105 days of age. (United States)

    Ohlerth, S; Augsburger, H; Abé, M; Ringer, S; Hatz, L; Braun, U


    The present study was undertaken to provide computed tomographic (CT) reference values for structures in the thorax of the calf. Six clinically healthy Holstein-Friesian calves were anaesthetized. Transverse pre- and postcontrast images with a reconstructed 1.5-mm slice thickness were obtained using a multislice-CT scanner at 6 different time points from birth to 105 days of age. Absolute and relative measurements of the trachea, heart, cranial and caudal vena cava, thoracic aorta, right and left principal bronchi, right and left caudal lobar bronchi and the accompanying branches of the right and left pulmonary artery and vein, thoracic lymph nodes and lung density were taken for every time point. All animals were euthanized after the last CT scan, and 4 calves were frozen to generate an atlas comparing gross anatomy with CT. During the study, 4 animals temporarily showed coughing and mucopurulent nasal discharge, and mild to moderate bronchopneumonia and pleuritis were diagnosed using CT. Animals recovered with treatment; however, mild to moderate CT changes remained throughout the study. Even in the 2 clinically normal animals, mild bronchopneumonia was diagnosed on CT.

  5. Parasites in harbour seals ( Phoca vitulina) from the German Wadden Sea between two Phocine Distemper Virus epidemics (United States)

    Lehnert, K.; Raga, J. A.; Siebert, U.


    Parasites were collected from 107 harbour seals ( Phoca vitulina) found on the coasts of Schleswig-Holstein, Germany, between 1997 and 2000. The prevalence of the parasites and their associated pathology were investigated. Eight species of parasites, primarily nematodes, were identified from the examined organs: two anisakid nematodes ( Pseudoterranova decipiens (sensu lato) , Contracaecum osculatum (sensu lato)) from the stomach, Otostrongylus circumlitus (Crenosomatidae) and Parafilaroides gymnurus (Filaroididae) from the respiratory tract, one filarioid nematode ( Acanthocheilonema spirocauda) from the heart, two acanthocephalans, Corynosoma strumosum and C. semerme (Polymorphidae), from the intestine and an ectoparasite, Echinophthirius horridus (Anoplura, Insecta). Lungworm infection was the most prominent parasitological finding and secondary bacterial bronchopneumonia the most pathogenic lesion correlated with the parasites. Heavy nematode burdens in the respiratory tract were highly age-related and more frequent in young seals. A positive correlation was observed between high levels of pulmonary infection and severity of bronchopneumonia. The prevalence of lungworms in this study was higher than in seals that died during the 1988/1989 Phocine Distemper Virus epidemic, and the prevalence of acanthocephalans and heartworms had decreased compared to findings from the first die-off.


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    Full Text Available Influenza virus causes mild-to-severe acute respiratory illness. H1N1 bronchopneumonia carries a higher mortality. MATERIALS AND METHODS Study was a prospective observational study conducted in a 24 bedded multidisciplinary ICU from January 2010 to December 2010. We included all adult patients admitted to our intensive care unit presenting with clinical features/suspicion of H1N1 bronchopneumonia and respiratory failure. These patients also subsequently tested positive for H1N1 Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR assay. Data was collected on demography, co-morbid illness, APACHE II and SOFA scores, organ failure and support. Outcome data on mortality, ICU LOS and ventilator days was also collected. RESULTS 28 patients with H1N1 bronchopneumonia required intensive care treatment. Majority of patients were females 60.7 % (n=17; of these 17 patients 7 patients were pregnant. Mean age of our patients was 50.6 (±19.1 years. Most common co-existing illnesses were diabetes mellitus (32.1% and hypertension (32.1% followed by bronchial asthma (10.7%; 85.7% patients had at least one organ dysfunction on admission, of which respiratory system was involved in 96.5% followed by renal system 57.1%. Patients were sick on admission as indicated by high APACHE II (17.75±6.5 and SOFA (5.25±1.8 scores. Mean PaO2/FiO2 on admission was 148.9±77.2. Severe ARDS (PaO2/FiO2 <100 was seen in 39.35% of patients. Of the 28 patients, 27 patients required ventilator support; 17 patients died out of 28 patients (mortality rate 60.7%. Higher APACHE II, SOFA scores and low PaO2/FiO2 on admission were identified as significant risk factors for mortality. CONCLUSION Critically ill H1N1 pneumonia patients present with multisystem involvement and they had a high mortality in our study.

  7. The roentgenological study of measles pneumonia

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    Shin, U.; Song, C. H.; Lee, H. Y.; Chung, H. K.; Joo, K. B. [Han Gang Sacred Heart Hospital, Hallym College, Seoul (Korea, Republic of)


    Measles is important infectious disease of pediatrics and pneumonia is the most commonest complication of measles. We have experienced 20 cases of pneumonia among 31 cases of measles in infant nursing home of Chae Chun during of December. 1981. The results a are as follows; 1. The incidence of measles pneumonia is 64.5%. 2. The patterns of pneumonic infiltration is : The pneumonia may have a bronchopneumonia (60%), Lobar pneumonia (15%), or combined form (35%). 3. Both lungs are involved by measles pneumonia: Right lung only (30%), Left lung only (5%), or Bilateral (65%). 4. Hilar lymphadenopathy (51.6%). Hilar lymphadenopathy with pneumonia (82.2%) and hilar lymphadenopathy without pneumonia (17.8%). 5. There is no pulmonary nodule which is noted frequently in atypical measles pneumonia as a seguale.

  8. Pathological findings and probable causes of the death of Stejneger's beaked whales (Mesoplodon stejnegeri) stranded in Japan from 1999 and 2011. (United States)

    Tajima, Yuko; Maeda, Kaori; Yamada, Tadasu K


    One hundred and twenty stranding events of Stejneger's beaked whales were reported in Japan between 1999 and 2011. The purpose of this study is to introduce pathological data and to discuss probable causes of death for 44 Stejneger's beaked whales among them. The significant pathological findings were the pulmonary edema, parasitic granulomatous nephritis, emaciation, amyloidosis, suppurative bronchopneumonia and so on. The probable causes of death were categorized as noninfectious in 43 of the cases, which included drowning, starvation and secondary amyloidosis. One individual was diagnosed with septicemia, which was the only example of an infectious disease. Because we could not always perform advanced analyses, such as microbiology tests, biotoxin examinations or contaminant analyses, the finality of our findings may be impaired. However, the present study has broad implications on the causes of death of Stejneger's beaked whales of the seas around Japan, which are valuable for the future studies and for the detection of emerging diseases.

  9. Total lymphoid irradiation in refractory systemic lupus erythematosus

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    Ben-Chetrit, E.; Gross, D.J.; Braverman, A.; Weshler, Z.; Fuks, Z.; Slavin, S.; Eliakim, M.


    In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental.

  10. Mycoplasmas associated with bovine conjunctivitis and keratoconjunctivitis. (United States)

    Naglić, T; Sanković, F; Madić, J; Hajsig, D; Seol, B; Busch, K


    In two separate herds of fattening calves a sudden-onset outbreak of ocular disease with profuse lacrimation occurred. The disease resembled the early stage of infectious bovine keratoconjunctivitis but after a few days the clinical signs of bronchopneumonia appeared. From conjunctival swabs Mycoplasma (M.) bovigenitalium, M. bovirhinis and infectious bovine rhinotracheitis (IBR) virus were isolated. Moraxella bovis infection was not established. In one of the herds M. bovigenitalium was also found in the pneumonic lungs of dead calves. In one herd M. bovoculi was isolated from a cow with chronic keratoconjunctivitis, housed together with affected calves. Mycoplasmas were not isolated from ocular swabs of six bulls originating from a Reproductive Centre with temporary occurrence of unilateral serous conjunctivitis resistant to antibiotic therapy.

  11. Experimental infection of sheep with Mycoplasma ovipneumoniae and Pasteurella haemolytica. (United States)

    Buddle, B M; Herceg, M; Davies, D H


    A group of Caesarian-derived, colostrum-deprived lambs was inoculated intranasally and intratracheally with a virulent Mycoplasma ovipneumoniae isolate selected from ovine mammary studies and propagated in an ovine mammary gland. Other groups of lambs were inoculated with M. ovipneumoniae in combination with Pasteurella haemolytica type Al or P. haemolytica alone. The M. ovipneumoniae isolate alone did not induce any specific pneumonic lesions in the lambs and when combined with P. haemolytica type Al did not increase the severity of the P. haemolytica-type lesions. Fifty percent of lambs inoculated with P. haemolytica developed a purulent and exudative bronchopneumonia with pleurisy and high titres of P. haemolytica were recovered from these lesions.


    Risco, David; Fernández-Llario, Pedro; Cuesta, Jesús M; García-Jiménez, Waldo L; Gonçalves, Pilar; Martínez, Remigio; García, Alfredo; Rosales, Rubén; Gómez, Luis; de Mendoza, Javier Hermoso


    Streptococcus suis is a recognized pathogen that may cause important diseases in pigs and humans. This microorganism has been repeatedly isolated from wild boar (Sus scrofa). However, its health implications for this wild species are still unknown. This article reports a detailed description of a fatal case of septicemia by S. suis affecting a young wild boar. The affected animal, about 15 days old, was found near death and exhibiting neurologic signs at a wild boar estate in southwestern Spain. Postmortem examination showed generalized congestion, brain hemorrhages and lobular pneumonia. Histopathological evaluation demonstrated the presence of meningitis and encephalitis with marked congestion and suppurative bronchopneumonia. Streptococcus suis serotype 2 isolates exhibiting important virulence factors (extracellular factor, muramidase-released protein, and suylisin) were isolated from the affected animal. This study confirms the presence of potentially virulent and zoonotic strains of S. suis in wild boar from Spain.

  13. Aspergillus-Related Lung Disease

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    Alia Al-Alawi


    Full Text Available Aspergillus is a ubiquitous dimorphic fungus that causes a variety of human diseases ranging in severity from trivial to life-threatening, depending on the host response. An intact host defence is important to prevent disease, but individuals with pre-existing structural lung disease, atopy, occupational exposure or impaired immunity are susceptible. Three distinctive patterns of aspergillus-related lung disease are recognized: saprophytic infestation of airways, cavities and necrotic tissue; allergic disease including extrinsic allergic alveolitis, asthma, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis and chronic eosinophilic pneumonia; and airway and tissue invasive disease -- pseudomembranous tracheobronchitis, acute bronchopneumonia, angioinvasive aspergillosis, chronic necrotizing aspergillosis and invasive pleural disease. A broad knowledge of these clinical presentations and a high index of suspicion are required to ensure timely diagnosis and treatment of the potentially lethal manifestations of aspergillus-related pulmonary disease. In the present report, the clinical, radiographic and pathological aspects of the various aspergillus-related lung diseases are briefly reviewed.

  14. Tracheobronchomegaly with multiple diverticula: a case report

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    Park, Chan Sup; Kim, Joung Sook [College of Medicine, Inha University, Incheon (Korea, Republic of)


    Chest radiograhs revealed evidences of dilatation of the trachea and both main bronchi, multiple air bubbles around the trachea and focal bronchopneumonia in right lower lobe. Tracheobronchomegaly is a rare condition characterized by marked dilatation of the trachea and main bronchi and frequently associated with tracheal diverticulosis, bronchiectasis, and recurrent lower respiratory tract infection. Mounier-Kuhn, in 1932, was the first to associate the presence of tracheobronchomegaly with the clinical syndrome of chronic, recurrent respiratory tract infection. Tracheobronchomegaly is believed to be extremely rare. To date, only 92 cases have been reported in the literatures. We recently encountered a case of tracheobronchomegaly associated with multiple diverticula formation. The diagnosis was made by chest radiography, computed tomography (CT), bronchography, and CT taken immediately after the bronchography.

  15. Disabling pansclerotic morphea of childhood with extracutaneous manifestations

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    Mahendra M Kura


    Full Text Available Disabling pansclerotic morphea (DPM of childhood is a rare generalized type of localized scleroderma (LS that is known to follow an aggressive course with pansclerotic lesions leading to severe joint contractures and consequent immobility. Mortality is due to complications of the disease such as bronchopneumonia, sepsis, or gangrene. There is no specific laboratory finding. Treatment protocols are still evolving for this severe recalcitrant disorder. Extracutaneous manifestations are rarely reported in DPM. We present the case of a 7-year-old girl with DPM with severe extracutaneous manifestations in the form of gastrointestinal and vascular disease, whose disease progressed rapidly. In spite of treatment with methotrexate, corticosteroids, and PUVA therapy, she ultimately succumbed to her illness due to sepsis.

  16. Postmortem findings in collared peccaries raised in captivity in northeastern Brazil

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    Jael S. Batista


    Full Text Available This study is a retrospective examination of diseases in collared peccaries that were diagnosed by the Veterinary Pathology Laboratory, Universidade Federal Rural do Semiárido. Necropsy and histological examination were performed from 2005 to 2010. Of the 50 necropsied collared peccaries, 24% died due to restraint and capture myopathy; 18% died from trauma; and the remainder was diagnosed with splenic hemangioma (6%, enterolithiasis (6%, gastritis (6%, gastric ulcer (4%, intestinal volvulus (4%, gastric volvulus (2%, mammary carcinoma (2%, polycystic kidney disease (2%, pyometra (2%, and suppurative bronchopneumonia (2%. Twelve animals remained undiagnosed, seven of which (14% were in advanced autolytic condition and five of which (10% had no gross or microscopic lesions that were compatible with disease. This paper describes illnesses that have not been reported in the collared peccary, focusing on their clinical and pathological aspects.

  17. Fatal parasitosis in blackbucks (Antilope cervicapra: a possible factor risk in hunting units

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    Ned de la Cruz-Hernández


    Full Text Available In February 2012, a reproductive group of 60 adult blackbucks (Antilope cervicapra from Veracruz, Mexico was relocated to hunting units in eastern and northeastern Mexico. Seven individuals died due to hemorrhagic parasitic, abomasitis and enteritis caused by Haemonchus spp., Setaria spp., and Trichostrongylids. Deaths were associated with hepatic necrosis, bilateral congestive distention of heart and fibrinonecrotic bronchopneumonia. Also Anaplasma marginale was identified. The blackbucks’ population displayed a general mortality rate of 11.67%, where 25% of total male and 9.62% of total female died. The mortality was controlled by segregation of all remaining blackbucks and the treatment for internal and external parasites (biting flies and ticks. After the treatment, no fatality cases related to parasitosis were recorded. The results presented here exhibit the high relevance of parasitosis as possible factor risk in the survival of tis specie.

  18. [Ultrastructural changes in the lung in acute adult respiratory distress syndrome]. (United States)

    Szemenyei, K; Széll, K; Kádas, L


    Morphological alterations of the lung in respiratory distress syndrome of adults (ARDS) were analyzed in 10 cases with traumatic-and septic shock, laryngitis subglottica descendens and bronchopneumonia. For the better understanding of the pathomechanism of the disease in addition to the standard methods, first of all ultrastructural alterations were studied. Two phases of the morphologic alterations could be distinguished, the phase of the destruction and the phase of the repair. These two processes are not sharply distinguishable. Genesis of the characteristic histological alterations (damage to the epithelial and endothelial cells, formation of hyaline membranes, microcoagulation, proliferation of the type II pneumocytes and fibroblasts, fibrosis) is discussed, with regard to the data of the literature.

  19. [Haemophilus influenzae and parainfluenzae in children. A retrospective study of 52 cases]. (United States)

    Guillot, F; Mory, C; Gire, R; Aït Hamouda, R


    Fifty-two children hospitalized in the Pediatric service of a general hospital between January 1978 and December 1979 were found to be infected with Haemophilus influenzae or para-influenzae (43 with H. influenzae and 9 with para-influenzae). Most of these children (34/52) were less than 4 years of age. The localizations of infections were as follow: 5 meningitis with satisfactory resolution except for 1 who developed slight deafness, 1 epiglotitis, 11 pneumonias or bronchopneumonias, 1 arthritis, 10 otitis medias, 6 conjunctivitis, 3 sinusitis, 10 upper airway infections and 1 neonatal infection. On 8 of these cases the patients were felt to be carriers of H. influenzae or para-influenzae, the signs and symptoms beeing not related to these bacteria. These results are compared with those found in the literature.

  20. Leukocyte adhesion deficiency syndrome: report on the first case in Chile and South America

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    Rodrigo Vásquez-De Kartzow

    Full Text Available CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is presented. His medical history included neonatal sepsis and delayed umbilical cord detachment. Laboratory studies showed marked leukocytosis with predominance of neutrophils and decreased CD11b and CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I [LAD type 1].

  1. Distemper in raccoons and foxes suspected of having rabies (United States)

    Habermann, R.T.; Herman, C.M.; Williams, F.P.


    1) Twenty-one raccoons and 3 red foxes were collected from areas where suspected rabies occurred. All were found to be nonrabid. 2) Distemper was diagnosed in 14 of the 21 raccoons by demonstrating intracytoplasmic and intranuclear inclusions in the brain and visceral tissues. Two of the 3 foxes were considered to have distemper; the clinical signs were typical and mouse inoculation tests were negative for rabies. 3) Deaths of the other 7 raccoons were attributed to: leishmaniasis 1, gastritis 1, bronchopneumonia 1, parasitism 2, car injury 1; 1 showed no significant lesions. The death of 1 fox was attributed to parasitism. 4) Distemper may be a frequent cause of death in raccoons and foxes, in epizootics which simulate rabies.

  2. Rare cause of natural death in forensic setting: hemophagocytic syndrome. (United States)

    Ondruschka, B; Habeck, J-O; Hädrich, C; Dreßler, J; Bayer, R


    We report about the case of a sudden unexpected death of a 25-year-old male suffering from infectious disease. An autopsy was ordered with no final premortem diagnosis. Microscopic and microbiological examination revealed a pneumococcal bronchopneumonia and hemophagocytic lesions in the bone marrow. After integrating clinical and autopsy reports as well as additional postmortem investigations, the cause of death was found to be infectious-triggered hemophagocytic syndrome (HPS) with a final cytokine storm. This seems to be the first reported fatal case of a reactive form of HPS associated to Streptococcus pneumoniae to the best of our knowledge. HPS is a dangerous hyperinflammation with highly characteristic, but nonspecific, laboratory findings and symptoms. Autopsies in such cases must be carefully performed and include systematic tissue sampling done by an experienced pathologist.

  3. The development of pneumoconiosis and its final stages in miners of the Karvina district

    Energy Technology Data Exchange (ETDEWEB)

    Pochmon, O.; Kratochvil, Z.


    The authors studied 63 retired miners from the Ostrava- Karvina coal mines who had a complicated form of pneumoco niosis. They had been repeatedly hospitalized in the department for tuberculosis and respiratory diseases, mostly because of a complicated respiratory illness. Under conditions of the Ostrava-Karvina mines, pneumoco niosis develops rapidly in proportion to the dust pollution the miners are exposed to. In the above 63 miners pneumoconiosis was in an advanced stage (type B and C according to the Geneva classification). The disease progressed most rapidly (within 10 years) in the group of drifters. Chronic bronchitis was found in 44% of the patients, lung emphysema in 56%, cor pulmonale in 57% of cases. The gravest complications in retired miners with an advanced stage of pneumoconiosis were exacerbated chronic bronchitis and bronchopneumonia endangering the lives of the patients.

  4. Pulmonary infections in swine induce altered porcine surfactant protein D expression and localization to dendritic cells in bronchial-associated lymphoid tissue

    DEFF Research Database (Denmark)

    Sørensen, C.M.; Holmskov, U.; Aalbæk, B.;


    Surfactant protein D (SP-D) is a pattern-recognition molecule of the innate immune system that recognizes various microbial surface-specific carbohydrate and lipid patterns. In vitro data has suggested that this binding may lead to increased microbial association with macrophages and dendritic...... among pSP-D, pathogens, phagocytic cells and dendritic cells. Lung tissue was collected from experimental and natural bronchopneumonias caused by Actinobacillus pleuropneumoniae or Staphylococcus aureus, and from embolic and diffuse interstitial pneumonia, caused by Staph. aureus or Arcanobacterium......SP-D through the specialized M cells overlying (BALT). In conclusion, we have shown that pSP-D expression in the lung surfactant is induced by bacterial infection by an aerogenous route rather than by a haematogenous route, and that the protein interacts specifically with alveolar macrophages...

  5. First reported case of Alcaligenes faecalis isolated from bronchoalveolar lavage in a patient with dengue hemorrhagic fever

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    Arun Agarwal


    Full Text Available Bacterial co-infections have been reported in association with dengue fever (DF and can exacerbate dengue infections. However, DF with acute respiratory distress syndrome and co-infection with Alcaligenes faecalis (A. faecalis has not been reported earlier. Most infections caused by A. faecalis are opportunistic. Urinary tract infection, bacterial keratitis, postoperative endophthalmitis, skin and soft tissue infections, bacteremia, meningitis, wound infections, and peritonitis in patients undergoing peritoneal dialysis have been described in association with A. faecalis. A. faecalis, a Gram-negative environmental organism rarely cause significant infections. Treatment can be difficult in some cases due to the high level of resistance to commonly used antibiotics. We report a case of fatal bronchopneumonia caused by extensively drug resistance A. faecalis in a patient of dengue hemorrhagic fever.


    Directory of Open Access Journals (Sweden)

    Majethia Nikhil


    Full Text Available BACKGROUND: Pneumonia remains the number one killer of children, taking the lives of 1.3 million in 2011 alone. More than 99% of all pneumonia deaths occur in developing countries. The majority of pneumonia cases are preventable and treatable, but clinical diagnosis is highly fallible in many cases and the frequency of morbid state is best assessed by post-mortem examination that may reveal diagnosis which may not be suspected clinically or may, in some way, discredit. AIMS: 1. To ascertain various pulmonary lesions in paediatric deaths. 2. To find incidence of pulmonary lesions. 3. To study the incidence of pulmonary tuberculosis, 4. To find incidence of pulmonary pathology directly and indirectly contributing to the death. SETTINGS: Lokmanya Tilak Municipal General Hospital, Sion, Mumbai. DESIGN: A retrospective observational study. METHODS AND MATERIAL: In this study pediatric age group of (0-15 years admitted in IPCU,NICU and Pediatric, Medicine and Surgery unit are included from the period of 2006-2013. The lung pathology in various diseases entities were studied and co-related with age, sex and clinical history. RESULTS: Of total 3606 autopsies, 642 were pediatric autopsies i.e. 17.8% of all autopsies, and 111 were neonatal autopsies. Of 642, 531(82.7% had primary lung pathology and 157(24.4% had secondary lung pathology. The common age group affected is < 5 years. Bronchopneumonia was the commonest pathology observed as primary lung pathology. Interstitial/viral pneumonia was 2nd most common of primary lung pathology Infective pathology was the most common lesions, of which bronchopneumonia was the most common pathology observed and tuberculosis contributed to 3%of primary lung pathologies. CONCLUSION: The most common lung lesion in pediatric age is infections, which are preventable and curative with appropriate measures. This study will help to improve mother child health services

  7. Clinical Characteristic and Outcome of Acute Lower Respiratory Tract Infection in Children with Congenital Heart Disease

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    Krystle Gabriela


    Full Text Available Background: Acute Lower Respiratory Tract Infection (ALRTI is the leading cause of deaths in children under 5 years of age worldwide, and has high morbidity and mortality in children with Congenital Heart Disease (CHD. The objective of this study was to obtain the incidence, clinical characteristic, and outcome of ALRTI children with CHD. Methods: A retrospective hospital-based study was conducted from January 2007–December 2011 to medical record of child patients with ALRTI and CHD in the Department of Child Health of Dr. Hasan Sadikin General Hospital, Bandung. The diagnosis of CHD was determined by echocardiography. The collected data was analyzed and presented in percentage shown in tables. Results : From 3,897 children who had ALRTI, there were 149 children with CHD (3.8%, with 11.4% of whom founded with recurrent episodes. This happened often in girls than boys with quite similar ratio of 1.37: 1.The majority of children (80% was under 1 year old of age, 72.5% with malnutrition, and 24.8% with severe malnutrition. Clinical symptoms mostly found were difficulty of breathing (98%, fever (85.2%, cough (75.2%, and runny nose (63.1%. The most common types of CHD were Patent Ductus Arteriosus (47.6%, followed by Ventricular Septal Defect (47%. Bronchopneumonia (86.6% was the common type of ALRTI. The length of stay was mostly less than 10 days (70.5%. From all the children 43.7% had complications, and 6.7% died. Conclusions: The ALRTI in children with CHD is not common and has good outcome. The majority for CHD lesions are Patent Ductus Arteriosus and Ventricular Septal Defect while for ALRTI is Bronchopneumonia.


    Directory of Open Access Journals (Sweden)

    Sabry M. El-Bahr


    Full Text Available The aim of the present study was to evaluate the diagnostic value of Acute Phase Proteins (APP, lipid profiles and proinflammatory cytokines in healthy and bronchopneumonic water buffalo calves. Therefore, sixty water buffalo calves (9±1 month old, 175±15 kg were divided into two equal groups, the first group represented healthy, control, calves whereas calves of the second group were affected with bronchopneumonia. Total leukocytic and differential counts were determined. Serum total protein, albumin, Triacylglyceol (TAG, low density lipoprotein cholesterol (LDL-c, High Density Lipoprotein cholesterol (HDL-c, Total cholesterol, Alanine Amino Transferase (ALT, Aspartate Amino Transferase (AST, Alkaline Phosphatase (ALP, Fibrinogen (Fb, Haptaglobin (Hp, Serum Amyloid A (SAA, Tumor Necrosis Factor-alpha (TNF-α, Interleukins (IL1β, IL-12 and Interferon-gamma (IFN-γ were also determined. In addition, Bronchoalveolar Lavage (BAL was collected and analyzed. The present findings indicated that, total leukocytic and neutrophils counts were significantly (p<0.05 higher in pneumonic water buffalo calves compare with control. The examined biochemical parameters were significantly (p<0.05 increased in pneumonic calves except for total protein, albumin, cholesterol and HDL-c which were significantly (p<0.05 lower compare with control. Serum concentrations of investigated APP and proinflammatory cytokines were significantly (p<0.05 higher in pneumonic water buffalo calves than those of control. The present study demonstrated that, APP, lipid profile and proinflammatory cytokines perhaps served as biomarkers of bronchopneumonia in water buffalo calves. However, future studies with higher baseline sampling are still needed to establish and validate reference values for APP and cytokines in water buffalo calves.

  9. Dysphagia as a risk factor for mortality in Niemann-Pick disease type C: systematic literature review and evidence from studies with miglustat

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    Walterfang Mark


    Full Text Available Abstract Niemann-Pick disease type C (NP-C is a rare neurovisceral disease characterised by progressive neurological deterioration and premature death, and has an estimated birth incidence of 1:120,000. Mutations in the NPC1 gene (in 95% of cases and the NPC2 gene (in approximately 4% of cases give rise to impaired intracellular lipid metabolism in a number of tissues, including the brain. Typical neurological manifestations include vertical supranuclear gaze palsy, saccadic eye movement abnormalities, cerebellar ataxia, dystonia, dysmetria, dysphagia and dysarthria. Oropharyngeal dysphagia can be particularly problematic as it can often lead to food or fluid aspiration and subsequent pneumonia. Epidemiological data suggest that bronchopneumonia subsequent to food or fluid aspiration is a major cause of mortality in NP-C and other neurodegenerative disorders. These findings indicate that a therapy capable of improving or stabilising swallowing function might reduce the risk of aspiration pneumonia, and could have a positive impact on patient survival. Miglustat, currently the only approved disease-specific therapy for NP-C in children and adults, has been shown to stabilise key neurological manifestations in NP-C, including dysphagia. In this article we present findings from a systematic literature review of published data on bronchopneumonia/aspiration pneumonia as a cause of death, and on the occurrence of dysphagia in NP-C and other neurodegenerative diseases. We then examine the potential links between dysphagia, aspiration, pneumonia and mortality with a view to assessing the possible effect of miglustat on patient lifespan.

  10. 支气管肺炎患儿治疗前后血清IGF-Ⅱ、IL-6、IL-8和TNF-α检测的临床意义%Clinical Significance of Determination of Changes of Serum IGF-Ⅱ,IL-6,IL-8,TNF-α Levels After Treatment in Children with Bronchopneamonia

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the clinical significance of changes of serum IGF-Ⅱ; IL-6; IL-8 and TNF-α levels after treatment in children with bronchopneamonia. Methods Serum IGF- Ⅱ; IL-6; IL-8 and TNF-a levels with RIA were detected both before and after treatment in 33 patients with children bronchopneumonia as well as in 35 controls. Results Before treatment; serum IGF-Ⅱ; IL-6; IL-8 and TNF-a levels were significantly higher in the patients than those in the controls ( P 0. 05 ) . Conclusions Seram IGF- Ⅱ; IL-6; IL-8 and TNF-a could take part in the pathogenesis of children bronchopneumonia in various ways and determination of these levels was clinically important.%目的:探讨支气管肺炎患儿治疗前后血清IGF-Ⅱ、IL-6、IL-8和TNF-α的变化及其临床意义.方法:应用放射免疫分析对33例支气管肺炎患儿进行了治疗前后血清IGF-Ⅱ、IL-6 、IL-8和TNF-α检测,并与35名正常健康儿作比较.结果:支气管肺炎患儿在治疗前血清IGF-Ⅱ、IL-6、IL-8和TNF-α水平显著地高于正常儿组(P<0.01).结论:IGF-Ⅱ、IL-6、IL-8和TNF-α以不同的方式参与了患儿的发病,其水平的检测对了解病情、指导治疗具有重要的临床价值.

  11. Barbiturate ingestion in three adult captive tigers (Panthera tigris and concomitant fatal botulism of one : clinical communication

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    J. H. Williams


    Full Text Available Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay

  12. Significance of peripheral blood interleukin-12 in capillary bronchiolitis patients%毛细支气管炎患儿外周血白细胞介素-12的意义

    Institute of Scientific and Technical Information of China (English)

    王秀芳; 杨慧彬; 宋丽; 张艳丽; 许春娜


    Objective To discuss the role of interleukin (IL)-12 in capillary bronchiolitis disease.Methods Fifty-nine cases of capillary bronchiolitis children under 2 years old were enrolled as the bronchiolitis group Ⅰ(n =28) and bronchiolitis group Ⅱ(n =31),36 cases of children with bronchopneumonia of the same age and 31 cases of children suffered from non-infectious diseases such as hernia and renal calculus of the same age were enrolled as bronchopneumonia control group and normal control group respectively.The peripheral blood IL-12 levels of four groups were detected by enzyme-linked immunosorbent assay.Results The levels of the peripheral blood IL-12 in bronchiolitis group Ⅰ,bronchiolitis group Ⅱ,bronchopneumonia control group and normal control group were (34.72±7.96) pg/ml,(55.30 ±6.72) pg/ml,(56.79±10.36) pg/ml and (61.23 ± 11.51) pg/ml respectively.The level of the peripheral blood IL-12 in bronchiolitis group I was significantly lower than that in bronchiolitis group Ⅱ,bronchopneumonia control group and normal control group respectively (P <0.05),and the level of the peripheral blood IL-12 in bronchiolitis group ⅡⅡ was significantly lower than that in bronchopneumonia control group and normal control group respectively (P < 0.05),but there was no significant difference between bronchopneumonia control group and normal control group (P > 0.05).Conclusion The level of IL-12 is one of the important factors for bronchiolitis disease,the reducing of serum level of IL-12 in children who have a high risk factor of capillary bronchiolitis is more obvious.%目的 探讨白细胞介素(interleukin,IL)-12在毛细支气管炎发病过程中的意义.方法 选取59例2岁以下毛细支气管炎患儿,分为毛支Ⅰ组(n=28)和毛支Ⅱ组(n=31),其中毛支Ⅰ组为具有特应质高危因素的患儿,毛支Ⅱ组为无特应质高危因素的患儿.同期住院的同年龄段支气管肺炎患儿36例和患有疝气、肾结石等

  13. 小儿支原体肺炎病情轻重的相关因素研究%Factors Related to the Severity of Symptoms in Children Mycoplasma Pneumoniae Pneumonia

    Institute of Scientific and Technical Information of China (English)

    徐哲; 陈华英; 马兵; 石平; 聂永红; 冯德刚; 刘亚军; 文虹; 刘燕


    with MPP were grouped by age: ^ 2 years of age ( 28 patients ), 3 ~ 5 years of age ( 79 patients ), and ^ 6 years of age ( 79 patients ) . They were also grouped by pneumonia pattern: bronchopneumonia group ( 94 patients ) and segmental/lobar pneumonia group ( 92 patients ) . In addition, the children aged ^ 6 years (79 patients ) were classified into three groups based on the severity of pneumonia: bronchopneumonia group (25 patients), mild segmental/lobar group (31 patients), and severe segmental/lobar group ( 23 patients). Ages, clinical symptoms, pulmonary lesions, laboratory findings and seroconversion rate of the 186 children with MPP were retrospectively analyzed. Results The fever in the three age groups all lasted ^7 days. There were significant differences among the three different age groups in bronchopneumonia, segmental/lobar, white blood cell count, neutrophil, lymphocyte, platelet count and C - reactive protein values ( P <0. 05) . The age, duration of fever, hospitalization, WBC count, neutrophil, lymphocyte, absolute lymphocyte count, platelet count, CRP, ESR and seroconversion rate were significantly different between the bronchopneumonia group and the segmental/lobar group ( P < 0. 05 ) . Hospitalization, CRP and seroconversion rate were significantly different among the bronchopneumonia group, the mild segmental/lobar group and the severe segmental/lobar group ( P < 0. 05 ). Conclusion In MPP, older children had longer fever and more severe pulmonary lesions. The severity of pulmonary lesions was associated with the absence of diagnostic IgM antibodies and lymphocyte count. Rapid pairing IgM serologic test is of great importance for early diagnosis of MPP.

  14. 粘附分子CD62P和CD44在毛细支气管炎患儿外周血中的表达及意义%Expression and significance of adhesion molecules CD62P and CD44 in peripheral blood of infants with bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    邹丽萍; 王伟; 张艳丽; 张艳; 王莉


    目的:探讨黏附分子CD62P和CD44在毛细支气管炎(简称毛支炎)患儿外周血中的表达及意义。方法选取2014年11月至2015年5月住院治疗的毛支炎发病期患儿33例和恢复期患儿19例为研究对象,同期选取支气管肺炎患儿30例为支气管肺炎组,非感染患儿26例为对照组。采用流式细胞术检测各组患儿外周血CD62P的表达百分比,ELISA法测定血清CD44的水平。结果毛支炎发病期组CD62P和CD44水平显著高于毛支炎恢复期组、支气管肺炎组及对照组(P<0.05);毛支炎恢复期组CD62P和CD44的水平仍高于对照组(P<0.05)。毛支炎发病期患儿外周血中黏附分子CD62P百分比与血清CD44的水平呈正相关(r=0.91, P<0.05)。结论黏附分子CD62P、CD44参与了毛细支气管炎的发病过程,其水平高低可反映毛细支气管炎炎症反应的严重程度。%ObjectiveTo explore the expression and signiifcance of the adhesion molecules CD62P and CD44 in the peripheral blood of infants with bronchiolitis.MethodsThirty-three infants with bronchiolitis in the acute phase and 19 infants with bronchiolitis in the recovery phase, who were hospitalized between November 2014 and May 2015, were enrolled. Thirty infants with bronchopneumonia and 26 infants without infection were enrolled as the bronchopneumonia group and the control group, respectively. The CD62P expression in the peripheral blood of each group was measured by lfow cytometry, and the CD44 level in serum was determined using ELISA.ResultsThe levels of the adhesion molecules CD62P and CD44 in the bronchiolitis group in the acute phase were signiifcantly higher than those in the bronchiolitis group in the recovery phase, the bronchopneumonia group, and the control group (P<0.05). The levels of the adhesion molecules CD62P and CD44 in the bronchiolitis group in the recovery phase were also signiifcantly higher than those in the control group (P<0.05). In the

  15. 毛细支气管炎患儿单次潮气肺功能测定的临床意义%Clinical significance of single tidal breathing testing in bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    李睿; 王吉安; 许家增; 杨慧敏


    目的:探讨毛细支气管炎患儿测定单次潮气肺功能的临床意义。方法检测和比较住院且<1岁的756例初次喘息毛细支气管炎患儿和115例支气管肺炎患儿的单次潮气肺功能。部分达峰时间比≤第20百分位和≥第80百分位的毛细支气管炎患儿出院1年后电话随访其喘息情况。结果毛细支气管炎患儿与支气管肺炎患儿比较,达峰时间比,达峰容积比,吸气时间,吸呼比,呼出25%、50%潮气容积时的呼气流速的差异有统计学意义(P均<0.05)。达峰时间比≤第20百分位的毛细支气管炎患儿1年内再喘息的比例为37.5%;达峰时间比≥第80百分位的毛细支气管炎患儿1年内再喘息比例为11.3%,两组差异有统计学意义(P<0.05)。结论单次潮气肺功能测定提示,阻塞程度较重的毛细支气管炎患儿再次喘息的可能性较大。%Objective To study clinical signiifcance of single tidal breathing testing in bronchiolitis. Methods Infants with bronchiolitis at ifrst wheezing (bronchiolitis group, n=756), and 115 infants with bronchopneumonia (bronchopneumonia group) hospitalized were enrolled. Tidal breathing parameters were analyzed in two groups. Bronchiolitis group was divided according to percentiles of the fraction of exhaled time at peak tidal expiratory lfow to total expiratory time (TPTEF/TE). The episodes of recurrent wheezing of infants below the 20th or above the 80th percentile of TPTEF/TE were followed up by phone calls within 1 year after discharge from the hospital. Results There were signiifcant differences in TPTEF/TE, VPEF/VE, Ti, Ti/Te, TEF75 and TEF50 between bronchiolitis group and bronchopneumonia group. The recurrent wheezing rate of infants with bronchiolitis below the 20th percentile of TPTEF/TE was signiifcantly higher than that above the 80th percentile of TPTEF/TE (37.5%vs 11.3%). Conclusions There is the greater possibility of recurrent wheezing in the infants with the

  16. Application of Whole Blood C-reactive Protein and White Blood Cell Count in Children With Pneumonia%全血C-反应蛋白与白细胞计数联合检测在小儿肺炎中的应用

    Institute of Scientific and Technical Information of China (English)



    Objective To analyze the application of the detection of whole blood C-reactive protein and white blood cell count in infantile pneumonia.Methods 120 cases of children with pneumonia in our hospital from August 2013 to July 2015 were selected, there were 70 cases of bacterial bronchopneumonia and 50 cases of viral pneumonia among them. To selected another 60 healthy cases, to compare the whole blood C-reactive protein and white blood cell count about two groups.ResultsThe whole blood C-reactive protein and white blood cell count of the children with bacterial bronchopneumonia was higher than the children with viral pneumonia and the healthy cases, the difference was statistically significant (P<0.05). The whole blood C-reactive protein and white blood cell count of the children with the viral pneumonia was signiifcantly was higher than the healthy cases, the difference was statistically signiifcant (P<0.05).Conclusion The combination of whole blood C- reactive protein and white blood cell count can identify the type of pneumonia in children with pneumonia, and can detect and conifrm the bacterial bronchopneumonia faster.%目的:分析全血C-反应蛋白与白细胞计数联合检测在小儿肺炎中的应用。方法选取2013年8月~至2015年7月本院收治的肺炎患儿120例,其中细菌性支气管肺炎70例,病毒性肺炎50例,另再选取60例健康儿童,观察比较三组患儿的全血C-反应蛋白与白细胞计数。结果细菌性支气管肺炎患儿的全血C-反应蛋白和白细胞计数显著高于病毒性肺炎及健康儿童,差异具有统计学意义(P<0.05);病毒性肺炎患儿的全血C-反应蛋白与白细胞计数高于健康儿童,差异有统计学意义(P<0.05)。结论全血C-反应蛋白与白细胞计数联合检测在小儿肺炎中可以鉴别肺炎类型,能更快的检测及确诊出细菌性支气管肺炎。

  17. Pneumonia enzoótica em javalis (Sus scrofa Enzootic pneumonia in wild boars (Sus scrofa

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    Roselene Ecco


    presented reduced growth rate, anorexia, lethargy, cough and dyspnea, especially after they were moved. High body temperature (40ºC in average was verified in some animals. Auscultation revealed moderate pulmonary crepitation and stertors. Pulmonary gross lesions were typical of lobular bronchopneumonia. Lung lesions were characterized by ventral-cranial consolidation in the majority of the cases. The color of affected pulmonary areas varied from diffuse dark red to mosaic pattern (dark red lobule intercalate by grayish lobule or diffusely grayish. The majority of the lungs had mucopurulent exsudate in the bronchial lumen that also drained from the parenchyma cut surface. Upon microscopy, the changes were characterized by purulent and histiocytic bronchopneumonia with necrotic foci. In some animals, there was BALT hyperplasia associated with perivascular and peribronchial plasma cells and lymphocytes infiltration in most of these cases. Bordetella bronchiseptica and Streptococcus spp. were the most frequently isolated bacteria. Immunohistochemistry evaluation demonstrated Mycoplasma hyopneumoniae on the luminal surface of bronchial and bronchiolar epithelial cells, and the DNA of bacteria was detected by PCR. This is the first report of bronchopneumonia in wild boars associated with M. hyopneumoniae infection.

  18. Concordance between clinical diagnosis and autopsy findings in two periods in the Hospital Universitario del Valle, Cali

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    Cortés Armando


    Full Text Available Context: Autopsy rates have declined all over the world recently. Clinical autopsy is considered to be an essential element for medical auditing and teaching and a useful tool for the evaluation of accuracy of the clinical diagnoses. Objetive: We describe the concordance between clinical diagnoses and autopsy findings in a tertiary care center. Materials and methods: We compared the diagnosis recorded on medical charts with reports of 100 autopsies performed between 1970 and 1975, and in 100 autopsies performed between 1990 and 1995 in the department of pathology of a terciary care hospital. The autopsy diagnoses were used as the “gold standard”. Results: The higher sensivity for diagnosis was observed for neoplasic disease in both period and for hemodinamics disorders, thrombosis and shock in 1970. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 73% and 64% of cases in period 1970 and 1990 respectively. The percent confirmation fell when the immediate terminal cause of death was considered, and in 36.5% of cases, the terminal cause was only diagnosed at autopsy. Of 200 adults patients, 62 (31% had an infectious disease at autopsy. In 25 (40.3% of 62 patients, the infectious disease diagnoses were unknown clinically. There are substantial discrepancies between clinical and autopsy diagnoses of infectious disease. The bronchopneumonia is the infectious disease most often missed clinically (24.5% of the cases, similar in both periods. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 63% of them were not suspected upon clinical diagnosis. The most frequently omitted diagnosis was bronchopneumonia. Iatrogenic injuries were very frequent, and approximately 28% of them were not described in clinical reports. Conclusions: Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration

  19. 300例小儿支气管肺炎血小板参数的变化及临床意义%Alternation of platelet parameter in 300 children with bionchopneumonia

    Institute of Scientific and Technical Information of China (English)

    刘春艳; 贾鹏; 刘文君


    OBJECTIVE To investigate the alternation and clinical significance of platelet parameter in 300 children with bron-chopneumonia. METHODS Observed the alternation of 300 children patients with bronchopneumonia (severe pneumonia 130, mild pneumonia 170) platelet count (PLT), platelet hematocrit (PCT) , mean platelet volume (MPV), platelet distribution width (PDW), and compared it with 80 cases in normal control group. RESULTS The platelet parameters of severe pneumonia-group and mild pneumonia-group at acute stage were significantly higher than those of control group (P < 0.01); 4 platelet parameters in severe pneumonia group were significantly higher than mild pneumonia group at acute stage (P< 0.01); 4 platelet parameter in severe pneumonia梘roup and mild pneumonia group at convalescence stage were lower than those at acute stage (P < 0.01) and all indices came back to normal at convalescence stage. CONCLUSION The results of this study suggest that the 4 platelet parameters of children with bronchial pneumonia abnormally go up at acute stage the extent of rise is closely connected with the suite of an illness.%目的 探讨小儿支气管肺炎4项血小板参数的变化及意义.方法 观察300例小儿支气管肺炎(重症肺炎130例,轻症肺炎170例)患者的血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)及血小板分布宽度(PDW)的变化,并与80例正常对照组比较.结果 重症肺炎组与轻症肺炎组急性期4项血小板参数比对照组均显著升高(P<0.01);重症肺炎组急性期4项血小板参数比轻症肺炎组急性期显著升高(P<0.01);重症肺炎组与轻症肺炎组恢复期4项血小板参数比急性期均显著降低(P<0.01),并恢复正常.结论 小儿支气管肺炎急性期4项血小板参数均异常升高,升高程度与病情相关.

  20. F. novicida-Infected A. castellanii Does Not Enhance Bacterial Virulence in Mice (United States)

    Ozanic, Mateja; Gobin, Ivana; Brezovec, Martin; Marecic, Valentina; Trobonjaca, Zlatko; Abu Kwaik, Yousef; Santic, Marina


    Francisella tularensis is a facultative intracellular bacterium that causes tularemia in humans and animals. Epidemiology of tularemia worldwide is often associated with water-borne transmission, which includes mosquitoes and amoebae as the potential host reservoirs of the bacteria in water environment. In vitro studies showed intracellular replication of F. tularensis within Acanthamoeba castellanii and Hartmanella vermiformis cells. While infection of amoeba by Legionella pneumophila has been shown to enhance infectivity of L. pneumophila the role of F. tularensis-infected protozoa in the pathogenesis of tularemia is not known. We used 6 h coculture of A. castellanii and F. novicida for investigation of the effect of inhaled amoeba on the pathogenesis of tularemia on in vivo model. Balb/c mice were infected intratracheally with F. novicida or with F. novicida-infected A. castellanii. Surprisingly, infection with F. novicida-infected A. castellanii did not lead to bronchopneumonia in Balb/c mice, and Francisella did not disseminate into the liver and spleen. Upon inhalation, F. novicida infects a variety of host cells, though neutrophils are the predominant cells early during infection in the lung infiltrates of pulmonary tularemia. The numbers of neutrophils in the lungs of Balb/c mice were significantly lower in the infection of mice with F. novicida-infected A. castellanii in comparison to group of mice infected only with F. novicida. These results demonstrate that following inoculation of mice with F. novicida-infected A. castellanii, mice did not develop tularemia. PMID:27242974

  1. [Injuries of the intracranial part of the carotid artery]. (United States)

    Sulla, I; Kafka, J; Mach, P; Výrostko, J; Kat'uch, V


    The objective of the submitted work was to draw attention to different types of injuries of the intracranial portion of the carotid artery and some problems associated with its solution. The investigated group comprised 7 subjects (2 women, 5 men) aged 19 to 76 years who attended between Jan. 1, 1995 and Feb. 29 2000 the Neurosurgical Clinic in Kosice with sequelae of injuries of the intracranial carotid artery. Two patients developed a pseudoaneurysm. In one case it was manifested by subarachnoid haemorrhage on the 24th day after a crash, in one instance by diplopia six weeks after a retrobulbar injection. Injury of the intracavernous portion of the artery was manifested in one instance by profuse epistaxis on the 17th day after a fall from a bicycle, four times by the development of a carotid-cavernous fistula several days to 3 years after the head injury. In the diagnosis classical as well as MR and digital subtraction angiography were used. In the patient with epistaxis classical carotid angiography was 3 times negative. The results are comparable with data in the literature. In three patients the problem was resolved by ligature of the common carotid artery on the neck. In another three it was necessary to use extra-intracranial trapping. One patient will be subjected to endovascular surgery. Two patients died (a 76-year-old woman from bronchopneumonia, a 19-year-old man from meningitis, despite a liquor fistula treated correctly by a patch).

  2. Nocardiosis in a Kidney-Pancreas Transplant

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    I. Fontana


    Full Text Available 34-year-old man with chronic renal and pancreas failure in complicated diabetic disease received a kidney-pancreas transplantation. On the 32nd postoperative day, an acute kidney rejection occurred and resolved with OKT3 therapy. The patient also presented refractory urinary infection by E. Fecalis and M. Morganii, and a focal bronchopneumonia in the right-basal lobe resolved with elective chemotherapy. During the 50th post-operative day, an intense soft tissue inflammation localized in the first left metatarsal-phalangeal articulation occurred (Figure 1 followed by an abscess with a cutaneous fistula and extension to the almost totality of foot area. The radiological exam revealed a small osteo-lacunar image localized in the proximal phalanx head of the first finger foot. From the cultural examination of the purulent material, N. Asteroides was identified. An amoxicillin-based treatment was started and continued for three months, with the complete resolution of infection This case is reported for its rarity in our casuistry, and for its difficult differential diagnosis with other potentially serious infections.

  3. Ground-glass opacity in diffuse lung diseases: high-resolution computed tomography-pathology correlation; Opacidades em vidro fosco nas doencas pulmonares difusas: correlacao da tomografia computadorizada de alta resolucao com a anatomopatologia

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    Santos, Maria Lucia de Oliveira; Vianna, Alberto Domingues; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Souza Junior, Arthur Soares [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Disciplina de Radiologia; Moraes, Heleno Pinto de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Patologia]. E-mail:


    Ground-glass opacity is a finding frequently seen in high-resolution computed tomography examinations of the chest and is characterized by hazy increased attenuation of lung, however without blurring of bronchial and vascular margins. Due to its un specificity, association with other radiological, clinical and pathological findings must be considered for an accurate diagnostic interpretation. In this paper were reviewed 62 computed tomography examinations of patients with diffuse pulmonary diseases of 14 different etiologies in which ground-glass opacity was the only or the most remarkable finding, and correlated this findings with pathology abnormalities seen on specimens obtained from biopsies or necropsies. In pneumocystosis, ground-glass opacities correlated histologically with alveolar occupation by a foaming material containing parasites, in bronchiole alveolar cell carcinoma with thickening of the alveolar septa and occupation of the lumen by mucus and tumoral cells, in paracoccidioidomycosis with thickening of the alveolar septa, areas of fibrosis and alveolar bronchopneumonia exudate, in sarcoidosis with fibrosis or clustering of granulomas and in idiopathic pulmonary fibrosis with alveolar septa thickening due to fibrosis. Alveolar occupation by blood was found in cases of leptospirosis, idiopathic hemo siderosis, metastatic kidney tumor and invasive aspergillosis whereas oily vacuole were seen in lipoid pneumonia, proteinaceous and lipo proteinaceous material in silico proteinosis and pulmonary alveolar proteinosis, and edematous fluid in cardiac failure. (author)

  4. An investigation into beef calf mortality on five high-altitude ranches that selected sires with low pulmonary arterial pressures for over 20 years. (United States)

    Neary, Joseph M; Gould, Daniel H; Garry, Franklyn B; Knight, Anthony P; Dargatz, David A; Holt, Timothy N


    Producer reports from ranches over 2,438 meters in southwest Colorado suggest that the mortality of preweaned beef calves may be substantially higher than the national average despite the selection of low pulmonary pressure herd sires for over 20 years. Diagnostic investigations of this death loss problem have been limited due to the extensive mountainous terrain over which these calves are grazed with their dams. The objective of the current study was to determine the causes of calf mortality on 5 high-altitude ranches in Colorado that have been selectively breeding sires with low pulmonary pressure (branding (6 weeks of age) in the spring to weaning in the fall (7 months of age). Clinical signs were recorded, and blood samples were taken from sick calves. Postmortem examinations were performed, and select tissue samples were submitted for aerobic culture and/or histopathology. On the principal study ranch, 9.6% (59/612) of the calves that were branded in the spring either died or were presumed dead by weaning in the fall. In total, 28 necropsies were performed: 14 calves (50%) had lesions consistent with pulmonary hypertension and right-sided heart failure, and 14 calves (50%) died from bronchopneumonia. Remodeling of the pulmonary arterial system, indicative of pulmonary hypertension, was evident in the former and to varying degrees in the latter. There is a need to better characterize the additional risk factors that complicate pulmonary arterial pressure testing of herd sires as a strategy to control pulmonary hypertension.

  5. A novel herpesvirus associated with respiratory disease in Bourke's parrots (Neopsephotus bourkii). (United States)

    Shivaprasad, H L; Phalen, D N


    A novel herpesvirus infection in nine Bourke's parrots (Neopsephotus bourkii, formerly Neophema bourkii) housed in an outdoor aviary comprised of multiple species of birds was diagnosed based on histopathology, electron microscopy and polymerase chain reaction (PCR). Clinical signs in the parrots included anorexia, ruffled feathers, depression, loss of weight and respiratory distress. The most common gross lesions were moderately congested and oedematous lungs and a mild fibrinous exudate in the air sacs and lumen of the trachea. Histological examination revealed mild to severe bronchopneumonia and airsacculitis with syncytial cells containing eosinophilic intranuclear inclusion bodies in most birds. Other less frequent changes included tracheitis, syringitis, sinusitis, rhinitis, otitis media and conjunctivitis. Attempts to culture the virus in chicken embryos and chicken embryo liver cells were unsuccessful. Examination by transmission electron microscopy of syncytial cells from the lungs of two birds revealed intranuclear virus particles typical of the family Herpesviridae. DNA from a novel herpesvirus was amplified from lung tissue by PCR using degenerate primers derived from conserved avian herpesvirus sequences. The virus belongs in the genus Iltovirus of the Alphaherpesvirinae subfamily. It is not closely related to Psittacid herpesvirus 1 that causes Pacheco's disease but does group phylogenetically with a clade of herpesviruses that cause respiratory disease in a number of avian species. The proposed name for this herpesvirus is Psittacid herpesvirus 3.

  6. Kangaroo mother program: physical growth and morbidity in a cohort of children, followed from 40 weeks of postconceptional age until first year.

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    Diana Palencia


    Full Text Available Introduction: Up to 40 weeks of postconceptional age, the kangaroo mother program at the Hospital Universitario del Valle has proved to be a safe alternative for premature babies’ management with a low birth weight. Objectives: To evaluate the physical growth and morbidity in children followed since 40 weeks up to 1 year in the program. Material and methods: A cohort study was performed in newborn infants admitted to the kangaroo mother program in the newborn unit at the Hospital Universitario del Valle, Cali, Colombia, with birth weight lower than 2000 g, from 40 weeks postconceptional age up to one year age, between August 2002 and July 2006. Information was collected about maternal age and morbidity, prenatal control, type of birth, gender, birth weight, gestational age, breastfeeding, thick motor development, physical growth, morbidity, readmissions, mortality and tests results. Results: A total of 390 infants were admitted to the program, with a 61% of captation. 65% of theirs mothers did not have prenatal control. Before completing the 40 weeks, 5.3% were readmitted due to anaemia and apnoea. After 40 weeks, 13% were readmitted by bronchopneumonia and acute diarrhoea. Most of them were allocated in the reference percentiles for weight and size. Size had a better growth than weight. The cumulated low weight incidence for age at 13 months was 22%. Conclusions: To increase the coverage of prenatal control program and to watch that the children receive prescribed iron and formulated folic acid.

  7. Histological findings in unclassified sudden infant death, including sudden infant death syndrome. (United States)

    Liebrechts-Akkerman, Germaine; Bovée, Judith V M G; Wijnaendts, Liliane C D; Maes, Ann; Nikkels, Peter G J; de Krijger, Ronald R


    Our objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports of 187 cases were available for systematic review, including brain autopsy in 135 cases. An explanation for the cause of death in 19 patients (10.2%) was found. Twelve patients had bronchopneumonia, 3 showed extensive aspiration, 2 had signs of a metabolic disorder, 1 had sepsis, and 1 had meningitis. Frequent nonspecific findings were congestion (66%), edema (47%), small hemorrhages (18%), and lymphoid aggregates (51%) in the lungs; congestion of the liver (23%); and asphyctic bleeding in the kidney (44%), adrenal gland (23%), and thymus (17%). Statistical associations were found for infection with starry sky macrophages in the thymus (P  =  0.004), with calcification (P  =  0.023), or with debris in the Hassal's corpuscles (P  =  0.034). In this study, in 10.2% of cases the histological findings were incompatible with SIDS or USID. Furthermore, several frequent nonspecific histological findings in the thymus that point toward an infection were found.

  8. Spontaneous and Dosing Route-related Lung Lesions in Beagle Dogs from Oral Gavage and Inhalation Toxicity Studies: Differentiation from Compound-induced Lesions. (United States)

    Mukaratirwa, Sydney; Garcia, Begonya; Isobe, Kaori; Petterino, Claudio; Bradley, Alys


    This study was conducted to characterize lung microscopic lesions in control beagle dogs from inhalation and oral gavage toxicity studies, to determine differences associated with the route of administration, and to discuss distinguishing features from compound-induced lung lesions. Samples from 138 control dogs from oral gavage studies and 124 control dogs from inhalation (vehicle control) studies were evaluated microscopically. There was no significant sex-related difference in the incidence of all lesions. Perivascular mononuclear cell infiltration, centriacinar mixed cell infiltration, bronchopneumonia, subpleural septal fibrosis, and alveolar macrophage accumulation were the most common lesions. Aspiration pneumonia was more common in dogs from gavage studies, suggesting reflux after gavage dosing or accidental administration of test formulation as possible causes. Centriacinar mixed cell infiltration was more common in dogs from inhalation studies, suggesting mild irritation by the vehicles used. Vascular lesions, which included pulmonary arteriopathy and smooth muscle mineralization, were observed in a few animals. Some of the spontaneous lesions are similar to lesions induced by test compounds. Compared to spontaneous lesions, compound-induced lesions tend to be multifocal or diffuse, follow a pattern of distribution (e.g., centriacinar, perivascular, and interstitial), show a dose response in the incidence and severity, and may show cell-specific toxicity.

  9. In vitro potential of equine DEFA1 and eCATH1 as alternative antimicrobial drugs in rhodococcosis treatment. (United States)

    Schlusselhuber, Margot; Jung, Sascha; Bruhn, Oliver; Goux, Didier; Leippe, Matthias; Leclercq, Roland; Laugier, Claire; Grötzinger, Joachim; Cauchard, Julien


    Rhodococcus equi, the causal agent of rhodococcosis, is a severe pathogen of foals but also of immunodeficient humans, causing bronchopneumonia. The pathogen is often found together with Klebsiella pneumoniae or Streptococcus zooepidemicus in foals. Of great concern is the fact that some R. equi strains are already resistant to commonly used antibiotics. In the present study, we evaluated the in vitro potential of two equine antimicrobial peptides (AMPs), eCATH1 and DEFA1, as new drugs against R. equi and its associated pathogens. The peptides led to growth inhibition and death of R. equi and S. zooepidemicus at low micromolar concentrations. Moreover, eCATH1 was able to inhibit growth of K. pneumoniae. Both peptides caused rapid disruption of the R. equi membrane, leading to cell lysis. Interestingly, eCATH1 had a synergic effect together with rifampin. Furthermore, eCATH1 was not cytotoxic against mammalian cells at bacteriolytic concentrations and maintained its high killing activity even at physiological salt concentrations. Our data suggest that equine AMPs, especially eCATH1, may be promising candidates for alternative drugs to control R. equi in mono- and coinfections.

  10. Cerebellar peduncle abscess secondary to disseminated strangles in a six-week-old miniature foal

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    Brianne Henderson


    Full Text Available During a strangles outbreak within a herd of minature horses, a six week old foal developed acute onset clinical signs of sepsis and neurological deficits. The foal was euthanized and submitted for post-mortem at the Animal Health Laboratories, Guelph Ontario. Gross post-mortem examination noted severe bronchopneumonia, hypopyon of the right eye and a singular cerebellar peduncle abscess. Culture of the lungs and cerebellum produced a pure growth of Streptococcus equi ssp. equi. Streptococcus equi ssp. equi, the causative agent of equine strangles, produces an acute pyrexia, purulent lymphadenopathy of submandibular and retropharyngeal lymph nodes. Commonly, lymph node abscesses rupture and resolve without complication. Rarely, complications may include: dissemination of the bacteria with diffuse abscess formation, immune mediated disease (purpura haemorrhagica, rarely abscess formation within the central nervous system (CNS can occur. These can be managed medically with appropriate antibiotics and drugs to reduce intra-cranial pressure, however surgical drainage and debulking of the abscess has been attempted successfully in a few cases.

  11. 'Lingering' opiate deaths? Concentration of opiates in medulla and femoral blood. (United States)

    Naso-Kaspar, Claire K; Herndon, Grant W; Wyman, John F; Felo, Joseph A; Lavins, Eric S; Gilson, Thomas P


    'Lingering death' cases occur when the circumstances of death indicate an opiate overdose, but measured opiate blood levels are only in the therapeutic range; death results from cardiac and respiratory depression. This study examined the relative concentration of opiates in femoral blood and in the medulla oblongata (sites for cardiac and respiratory control) from 41 cases to determine whether a difference in opiate concentration might explain lingering deaths. Opiates from blood and medulla were analyzed using GC-EI-MS in selective ion monitoring mode. Results were correlated with gross and microscopic findings of the lungs and with cause and manner of death. Opiate concentrations for morphine, codeine and 6-acetylmorphine (6-AM) were higher in the medulla than in blood. The brain: blood ratio for the analytes demonstrated an increasing ratio from morphine, to codeine, to 6-AM (1.42, 2.48 and 4.86), which corresponds to the relative lipophilicity of these analytes. The average right and left lung weights were 762 and 668 g, respectively. Histologic examination showed edema, and/or polarizable microemboli, acute bronchopneumonia and acute bronchitis. The preferential distribution of opiates to medulla suggests that lingering opiate deaths may be explained, at least in part, because of higher relative concentrations of drug in brain, compared with femoral blood.


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    Mateja eOzanic


    Full Text Available Francisella tularensis is a facultative intracellular bacterium that causes tularemia in humans and animals. Epidemiology of tularemia worldwide is often associated with water-borne transmission, which includes mosquitoes and amoebae as the potential host reservoirs of the bacteria in water environment. In vitro studies showed intracellular replication of F. tularensis within Acanthamoeba castellanii and Hartmanella vermiformis cells. While infection of amoeba by Legionella pneumophila has been shown to enhance infectivity of L. pneumophila the role of F. tularensis-infected protozoa in the pathogenesis of tularemia is not known. We used 6 h coculture of A. castellanii and F. novicida for investigation of the effect of inhaled amoeba on the pathogenesis of tularemia on in vivo model. Balb/c mice were infected intratracheally with F. novicida or with F. novicida-infected A. castellanii. Surprisingly, infection with F. novicida-infected A. castellanii did not lead to bronchopneumonia in Balb/c mice, and Francisella did not disseminate into the liver and spleen. Upon inhalation, F. novicida infects a variety of host cells, though neutrophils are the predominant cells early during infection in the lung infiltrates of pulmonary tularemia. The numbers of neutrophils in the lungs of Balb/c mice were significantly lower in the infection of mice with F. novicida-infected A. castellanii in comparison to group of mice infected only with F. novicida. These results demonstrate that following inoculation of mice with F. novicida-infected A. castellanii, mice did not develop tularemia.

  13. Infecção por Chryseobacterium indologenes: relato de um caso Chryseobacterium indologenes infection: a case report

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    Renata de Souza Ferreira


    Full Text Available Relatamos um caso de infecção por Chryseobacterium indologenes, presente na cultura de aspirado traqueal em paciente sob ventilação mecânica invasiva, revisando os aspectos epidemiológicos, microbiológicos e o tratamento na unidade de terapia intensiva. Paciente do sexo masculino, 30 anos, internado com quadro de aplasia de medula idiopática e neutropenia febril foi transferido para a unidade de terapia intensiva com quadro de broncopneumonia e sepse grave de origem pulmonar. A maioria dos casos já relatados de pacientes com infecção por Chryseobacterium indologenes apresentavam patologias graves associadas e infecções polimicrobianas que podem dificultar a interpretação da efetividade da terapia antimicrobiana contra este agente.A case of Chryseobacterium indologenes infection is reported, identified in an invasive mechanic ventilation patient's tracheal aspiration material. Epidemiological, microbiological, and intensive care unit therapy aspects are discussed. The patient was a 30 years-old male, admitted with idiopathic medullary aplasia and febrile neutropenia, referred to the intensive care unit with severe bronchopneumonia and sepsis of pulmonary origin. Most of the previously reported Chryseobacterium indologenes infection cases were associated with severe diseases and polymicrobial infections which could make difficult interpreting antimicrobial therapy options against this agent.

  14. Bronchiolitis Obliterans Organizing Pneumonia in Swine Associated with Porcine Circovirus Type 2 Infection

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    Ching-Chang Cheng


    Full Text Available Bronchiolitis obliterans organizing pneumonia (BOOP is a chronic respiratory disease. Although the pathogenesis of BOOP is still incompletely understood, BOOP is responsive to steroids and has a good prognosis. In our five pigs with chronic postweaning multisystemic wasting syndrome (PMWS, typical BOOP lesions were revealed. All five porcine lungs showed typical intraluminal plugs, and porcine circovirus type 2 (PCV2 was identified. They also exhibited similar pathologic findings such as proliferation of type II pneumocytes and myofibroblasts (MFBs, extracellular collagen matrix (ECM deposition, and fragmentation of elastic fibers. MFBs migration correlative molecules, for instance, gelatinase A, B and osteopontin, appeared strongly in the progressing marginal area of polypoid intraluminal plugs of fibrotic lesion. These molecules colocalized with the active MFBs. Both gelatinase activity and intercellular level of active MFBs were significantly increased (<.05. Porcine chronic bronchopneumonia leads to BOOP and it is associated with PCV2 persistent infection. Swine BOOP demonstrates similar cellular constituents with human BOOP. Perhaps their molecular mechanisms of pathogenesis operate in a similar way. Thus we infer that the swine BOOP can be considered as a potential animal model for human BOOP associated with natural viral infection. Moreover, it is more convenient to obtain samples.

  15. Two different avipoxviruses associated with pox disease in Magellanic penguins (Spheniscus magellanicus) along the Brazilian coast. (United States)

    Niemeyer, Claudia; Favero, Cíntia M; Kolesnikovas, Cristiane K M; Bhering, Renata C C; Brandão, Paulo; Catão-Dias, José Luiz


    A novel avipoxvirus caused diphtheritic lesions in the oesophagus of five and in the bronchioli of four Magellanic penguins (Spheniscus magellanicus) and also cutaneous lesions in eight Magellanic penguins housed in outdoor enclosures in a Rehabilitation Centre at Florianópolis, Santa Catarina State, Brazil. At the same time, another avipoxvirus strain caused cutaneous lesions in three Magellanic penguins at a geographically distinct Rehabilitation Centre localized at Vila Velha, Espírito Santo State, Brazil. Diagnosis was based on clinical signs, histopathology and use of the polymerase chain reaction (PCR). Clinical signs in the penguins included cutaneous papules and nodules around eyelids and beaks, depression and restriction in weight gain. The most common gross lesions were severely congested and haemorrhagic lungs, splenomegaly and cardiomegaly. Histological examination revealed Bollinger inclusion bodies in cutaneous lesions, mild to severe bronchopneumonia, moderate periportal lymphocytic hepatitis, splenic lymphopenia and lymphocytolysis. Other frequent findings included necrotizing splenitis, enteritis, oesophagitis, dermatitis and airsacculitis. Cytoplasmic inclusion bodies were seen within oesophageal epithelial cells in five birds and in epithelial cells of the bronchioli in four penguins. DNA from all samples was amplified from skin tissue by PCR using P4b-targeting primers already described in the literature for avipoxvirus. The sequences showed two different virus strains belonging to the genus Avipoxvirus of the Chordopoxvirinae subfamily, one being divergent from the penguinpox and avipoxviruses already described in Magellanic penguins in Patagonia, but segregating within a clade of canarypox-like viruses implicated in diphtheritic and respiratory disease.

  16. Pleuritis and suppurative pneumonia associated with a hypermucoviscosity phenotype of Klebsiella pneumoniae in California sea lions (Zalophus californianus). (United States)

    Jang, Spencer; Wheeler, Liz; Carey, Roberta B; Jensen, Bette; Crandall, Claudia M; Schrader, Kimmi N; Jessup, David; Colegrove, Kathleen; Gulland, Frances M D


    The aim of this study is to document the isolation of a hypermucoviscosity (HMV) phenotype of Klebsiella pneumoniae from 25 cases of suppurative pneumonia and pleuritis and two cases of abscesses in California sea lions (Zalophus californianus) from the central California coast, representing the first report of this zoonotic pathogen from the marine environment and only the second report in non-humans. Animals died 2h to 4 days after first being observed sick on beaches. Clinical signs varied from dyspnoea to coma. Gross post-mortem examination of 25 cases revealed fibrinous pleuritis, copious pus in the pleural cavity and suppurative bronchopneumonia. K. pneumoniae isolates obtained from lung and pleural swabs and the hepatic and subcuticular abscesses were highly mucoid on blood agar culture media and were positive to the "string test". Twenty-one of the 27 isolates were examined by PCR and all were positive for rmpA and K2wyz and negative for K1magA genes. Although pneumonia and pleuritis have previously commonly been observed in marine mammals, their association with pure cultures of a zoonotic bacteria, K. pneumoniae HMV phenotype, has not. This report provides further evidence of the role marine mammals play as sentinels of health risks to humans from coastal waters.

  17. [Evaluation of the treatment with levodropropizine of respiratory diseases in children]. (United States)

    Fiocchi, A; Zuccotti, G V; Vignati, B; Pogliani, L; Sala, M; Riva, E


    Sometimes, antitussives can be a valid adjuvant to respiratory tract infections treatment. Although not always needed, this therapeutic support can be extremely useful in selected cases, and when patient is resident and monitored. In this line, the efficacy of a new peripheral antitussive, levodropropizine (Dompé farmaceutici, Milan), has been evaluated in 70 children inpatients of the Pediatric Department at san Paolo Hospital - Milan University - from September 1987 to May 1988. Thirty one male and 29 female children, aged 4 years and 6 months +/- 3 years and 5 months, suffering from various respiratory tract diseases were included in the study. Underlying diseases were represented by 21 acute bronchitis, 20 asthmatic attacks, 18 bronchopneumonia, 11 tracheitis, 6 acute episodes of chronic bronchitis, 2 hypoglottis laryngitis, 1 pertussis, 1 spontaneous pneumothorax. All parents gave their oral informed consent. The basic treatments were antibiotics in 44 patients associated or not with beta 2 agonists (31), theophylline (15), corticosteroids via aerosol (9) or parenterally (3), immunomodulators (2). Treatment with levodropropizine in the oral drops formulation at 2 mg pro kg a day was continued for 5 days and withdrawn according to the clinical evolution. Cough was registered by means of appropriate record forms given to the parents as well as with 120' tape recording whenever possible, i.e. 60 minutes before and 60 minutes after drug administration, on day one and 2. At treatment end, parents and investigator gave an antitussive efficacy judgement. Tolerability was evaluated as per clinical evolution and laboratory parameters.

  18. Conjunctivitis, tracheitis, and pneumonia associated with herpesvirus infection in green sea turtles. (United States)

    Jacobson, E R; Gaskin, J M; Roelke, M; Greiner, E C; Allen, J


    Fourteen juvenile (15- to 20-month-old) green sea turtles (Chelonia mydas), representative of a group of sea turtles with clinical signs of respiratory tract disease, were euthanatized and submitted for necropsy. Macroscopically, lesions included periglottal necrosis, tracheitis with intraluminal caseous and laminated necrotic debris, and severe pneumonia. Several turtles had caseous conjunctival exudate covering the eyes. Microscopically, the turtles had fibrinonecrotic inflammation around the glottal opening, tracheitis, and severe bronchopneumonia and interstitial pneumonia. In multifocal areas, periglottal and tracheal epithelial cells adjacent to areas of necrosis had hypertrophic nuclei with amphophilic intranuclear inclusions. A mixed population of primarily gram-negative microorganisms was isolated from the tracheal and glottal lesions. Attempts at viral isolation in cultures of green sea turtle kidney cells resulted in the development of cytopathic effects characterized by giant cell formation and development of intranuclear inclusions. Using electron microscopy, intranuclear viral particles (88 to 99 nm in diameter) were seen in inclusion-containing tracheal and glottal epithelial cells and infected green sea turtle kidney cells; particles were consistently seen enveloping from nuclear membranes, and mature particles (132 to 147 nm) were found in the cytoplasm. On the basis of size, conformation, location, and presence of an envelope, the particles most closely resembled those of herpes-viruses.

  19. A retrospective study of acute pertussis in Hasan Sadikin Hospital-Indonesia

    Institute of Scientific and Technical Information of China (English)

    Heda Melinda Nataprawira; Evelyn Phangkawira


    Objective: To describe the representation of pertussis diagnosis in children. Methods: A retrospective observational study was performed on pediatric pertussis and pertussis-like syndrome registry for children <14 years of age documented from October 2008 to December 2014 in Hasan Sadikin Hospital, Indonesia. Demographic data, signs and symptoms at presentation, case definition (probable, confirmed), possible pertussis contact, pertussis vaccination status, results of Bordetella pertussis (B. pertussis) culture, complications, and outcome were recorded. Results:Sixty-one probable and two confirmed pertussis were documented. Male and female ratio was 1:1, mostly presented with shortness of breath, 24 (38%) subjects had posttussive vomiting, 10 (16%) had whooping-cough. Ten patients (16%) were reported to have adult possible pertussis contact. Only 2 infants had previous pertussis vaccination. All subjects presented in the second week of illness were all diagnosed as bronchopneumonia but two. The mean age was 6 months, ranging from 0−50 months. One subject required mechanical ventilation. B. pertussis culture was performed only in 35 (56%) subjects but positive only in two. There were no fatal cases, 55 (87%) including the subject who need mechanical ventilation had good outcome. Conclusions: Mostly patients were admitted on paroxysmal phase when no more active B. pertussis could be found from nasopharyngeal secret. A rigorous history taking particularly excessive cough, posttussive vomitting, and pertussis vaccination status need to be taken into account.

  20. Inhalation toxicity of lithium combustion aerosols in rats

    Energy Technology Data Exchange (ETDEWEB)

    Greenspan, B.J.; Allen, M.D.; Rebar, A.H.


    Studies of the acute inhalation toxicity of lithium combustion aerosols were undertaken to aid in evaluating the health hazards associated with the proposed use of lithium metal in fusion reactors. Male and female F344/Lov rats, 9-12 wk of age, were exposed once for 4 h to concentrations of 2600, 2300, 1400, or 620 mg/m/sup 3/ of aerosol (MMAD = 0.69, sigma/sub g/ = 1.45) that was approximately 80% lithium carbonate and 20% lithium hydroxide to determine the acute toxic effects. Fourteen-day LC50 values (with 95% confidence limits) of 1700 (1300-2000) mg/m/sup 3/ for the male rats and 2000 (1700-2400) mg/m/sup 3/ for the female rate were calculated. Clinical signs of anorexia, dehydration, respiratory difficulty, and perioral and perinasal encrustation were observed. Body weights were decreased the first day after exposure in relation to the exposure concentration. In animals observed for an additional 2 wk, body weights, organ weights, and clinical signs began to return to pre-exposure values. Histopathologic examination of the respiratory tracts from the animals revealed ulcerative or necrotic laryngitis, focal to segmental ulcerative rhinitis often accompanied by areas of squamous metaplasia, and, in some cases, a suppurative bronchopneumonia or aspiration pneumonia, probably secondary to the laryngeal lesions. The results of these studies indicate the moderate acute toxicity of lithium carbonate aerosols and will aid in the risk analysis of accidental releases of lithium combustion aerosols.

  1. Mortality study for a decade: ischemic stroke in the elderly.

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    Javier J. García Zacarías


    Full Text Available Cerebrovascular diseases are among the top three causes of death in Cuba and the world, about 80 % of these patients belong to Ischemic Stroke. The objective of this paper is to describe the clinical and developmental profile of patients who died of Ischemic Stroke. A descriptive, prospective research, cross- sectional study was made, the sample included all deaths from ischemic stroke at the University Hospital "Camilo Cienfuegos" Sancti Spiritus, between January 1st, 2001 and December 31, 2010, and persons over 60 years of age with necropsy performed. Atherothrombotic stroke was the most frequent category, the highest mortality rates were observed in persons over 80 years of age and in females, hypertension, ischemic heart disease and transient ischemic attack were the main significant medical history; most patients were admitted in the stroke unit and died in Middle Progressive Care, cerebral edema and intracranial hypertension and hypostatic bronchopne umonia were complications and specific main causes of most frequent death. Value of cerebral edema and hypostatic bronchopneumonia as clinical complications and causes of death in patients investigated is confirmed.

  2. Comparison of passively transferred antibodies in bighorn and domestic lambs reveals one factor in differential susceptibility of these species to Mannheimia haemolytica-induced pneumonia. (United States)

    Herndon, Caroline N; Shanthalingam, Sudarvili; Knowles, Donald P; Call, Douglas R; Srikumaran, Subramaniam


    Mannheimia haemolytica consistently causes fatal bronchopneumonia in bighorn sheep (BHS; Ovis canadensis) under natural and experimental conditions. Leukotoxin is the primary virulence factor of this organism. BHS are more susceptible to developing fatal pneumonia than the related species Ovis aries (domestic sheep [DS]). In BHS herds affected by pneumonia, lamb recruitment is severely impaired for years subsequent to an outbreak. We hypothesized that a lack of maternally derived antibodies (Abs) against M. haemolytica provides an immunologic basis for enhanced susceptibility of BH lambs to population-limiting pneumonia. Therefore, the objective of this study was to determine the titers of Abs directed against M. haemolytica in the sera of BH and domestic lambs at birth through 12 weeks of age. Results revealed that BH lambs had approximately 18-fold lower titers of Ab against surface antigens of M. haemolytica and approximately 20-fold lower titers of leukotoxin-neutralizing Abs than domestic lambs. The titers of leukotoxin-neutralizing Abs in the serum and colostrum samples of BH ewes were approximately 157- and 50-fold lower than those for domestic ewes, respectively. Comparatively, the higher titers of parainfluenza 3 virus-neutralizing Abs in the BH lambs ruled out the possibility that these BHS had an impaired ability to passively transfer Abs to their lambs. These results suggest that lower levels of leukotoxin-neutralizing Abs in the sera of BH ewes, and resultant low Ab titers in their lambs, may be a critical factor in the poor lamb recruitment in herds affected by pneumonia.

  3. F. novicida-Infected A. castellanii Does Not Enhance Bacterial Virulence in Mice. (United States)

    Ozanic, Mateja; Gobin, Ivana; Brezovec, Martin; Marecic, Valentina; Trobonjaca, Zlatko; Abu Kwaik, Yousef; Santic, Marina


    Francisella tularensis is a facultative intracellular bacterium that causes tularemia in humans and animals. Epidemiology of tularemia worldwide is often associated with water-borne transmission, which includes mosquitoes and amoebae as the potential host reservoirs of the bacteria in water environment. In vitro studies showed intracellular replication of F. tularensis within Acanthamoeba castellanii and Hartmanella vermiformis cells. While infection of amoeba by Legionella pneumophila has been shown to enhance infectivity of L. pneumophila the role of F. tularensis-infected protozoa in the pathogenesis of tularemia is not known. We used 6 h coculture of A. castellanii and F. novicida for investigation of the effect of inhaled amoeba on the pathogenesis of tularemia on in vivo model. Balb/c mice were infected intratracheally with F. novicida or with F. novicida-infected A. castellanii. Surprisingly, infection with F. novicida-infected A. castellanii did not lead to bronchopneumonia in Balb/c mice, and Francisella did not disseminate into the liver and spleen. Upon inhalation, F. novicida infects a variety of host cells, though neutrophils are the predominant cells early during infection in the lung infiltrates of pulmonary tularemia. The numbers of neutrophils in the lungs of Balb/c mice were significantly lower in the infection of mice with F. novicida-infected A. castellanii in comparison to group of mice infected only with F. novicida. These results demonstrate that following inoculation of mice with F. novicida-infected A. castellanii, mice did not develop tularemia.

  4. Heart transplantation in neonates and children. Intermediate-term results

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    Estela Azeka


    Full Text Available OBJECTIVE: To assess intermediate-term outcome in children who have undergone orthotopic heart transplantation. METHODS: We carried out a longitudinal and prospective study between October '92 and June '99 comprising 20 patients with ages ranging from 12 days to 7 years (mean of 2.8 years. We employed a double immunosuppression protocol with cyclosporine and azathioprine and induction therapy with polyclonal antithymocyte serum. Survival and complications resulting from the immunosuppression protocol were analyzed. RESULTS:The double immunosuppression protocol and the induction therapy with polyclonal antithymocyte serum resulted in an actuarial survival curve of 90% and 78.2% at 1 and 6 years, respectively, with a mean follow-up period of 3.6 years. One patient died due to acute rejection 40 days after transplantation; another patient died 2 years after transplantation due to lymphoproliferative disorder; a third patient died because of primary failure of the graft; and a fourth patient died due to bronchopneumonia. The major complications were as follows: acute rejection, infection, nephrotoxicity, and systemic hypertension. The means of rejection and infection episodes per patient were 2.9 and 3.4, respectively. After one year of transplantation, a slight reduction in the creatinine clearance and systemic hypertension were observed in 7 (38.9% patients. CONCLUSION: Heart transplantation made life possible for those patients with complex congenital heart diseases and cardiomyopathies in refractory congestive heart failure constituting a therapeutical option for this group of patients in the terminal phase.

  5. Novel mastadenovirus infection and clinical disease in a pygmy marmoset (Callithrix [Cebuella] pygmaea). (United States)

    Gál, János; Hornyák, Ákos; Mándoki, Míra; Bakonyi, Tamás; Balka, Gyula; Szeredi, Levente; Marosán, Miklós; Ludányi, Tibor; Forgách, Petra; Sós, Endre; Demeter, Zoltán; Farkas, Szilvia L


    We describe the detection and successful isolation of a novel mastadenovirus from a pygmy marmoset (Callithrix [Cebuella] pygmaea) that died following an episode of severe respiratory signs. Pathologic/histopathologic examination revealed hydrothorax and catarrhal bronchopneumonia with pronounced desquamation of the bronchiolar epithelial cells, while in other airways a marked hyperplasia of the epithelial lining and numerous giant cells could be observed. We obtained partial sequence data from the adenoviral DNA-dependent DNA-polymerase gene of the isolated strain and analyses of this region showed the highest level of identity to the recently described bat adenoviruses (strains PPV1 and TJM) and the type 2 canine adenovirus. Similar results were gained by phylogenetic calculations indicating that this novel marmoset adenovirus is only distantly related to reference Old and New World primate adenoviruses and formed a monophyletic group with bat and canine adenoviruses and the equine adenovirus 1. Even though the source of the infection remained unknown, our results could imply the possibility of a cross-species transmission of the virus from an anonymous host to the pygmy marmoset.

  6. Sulphur Mustard Poisoning and Its Complications in Iranian Veterans

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    Beeta Balali-Mood


    Full Text Available Sulphur mustard is a chemical warfare agent, which was largelyused during the World War One and in Iraq-Iran conflict. It mayalso be used as a chemical terrorism agent. Therefore, medicalprofessions should have sufficient knowledge and be preparedfor medical intervention of any such chemical attack.Sulphur mustard exerts direct toxic effects on the eyes, skin,and respiratory tract, with subsequent systemic actions on thenervous, immunologic, hematologic, digestive, and reproductivesystems. It is an alkylating agent that affects DNA synthesis andthus, delayed complications have been considered since theWorld War One. Cases of malignancies in the target organs particularlyin hematopoietic, respiratory, and digestive systemswere reported. Common delayed respiratory complications includechronic bronchitis, bronchiectasis, frequent bronchopneumonia,and pulmonary fibrosis, all of which tend to deterioratewith time. Severe dry skin, delayed keratitis, and reduction ofnatural killer cells with subsequent increased risk of infectionsand malignancies are also among the most distressing long-termconsequences of sulphur mustard intoxication. However, despiteextensive research that has been conducted on Iranian veteransduring the past decades, major gaps continue to remain in thesulphur mustard literature. Immunological and neurological dysfunctionsand the relationship between exposure to sulphur mustardand mutagenicity, carcinogenicity, and teratogenicity areimportant fields that require further studies, particularly on Iranianveterans with chronic health problems caused by sulphurmustard poisoning. There is also a paucity of information on themedical management of acute and delayed toxic effects of sulphurmustard poisoning, a subject that greatly challenges themedical professions.

  7. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province.

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    Rubén Bembibre Taboada


    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

  8. Fatal canine distemper infection in a pack of African wild dogs in the Serengeti ecosystem, Tanzania. (United States)

    Goller, Katja V; Fyumagwa, Robert D; Nikolin, Veljko; East, Marion L; Kilewo, Morris; Speck, Stephanie; Müller, Thomas; Matzke, Martina; Wibbelt, Gudrun


    In 2007, disease related mortality occurred in one African wild dog (Lycaon pictus) pack close to the north-eastern boundary of the Serengeti National Park, Tanzania. Histopathological examination of tissues from six animals revealed that the main pathologic changes comprised interstitial pneumonia and suppurative to necrotizing bronchopneumonia. Respiratory epithelial cells contained numerous eosinophilic intracytoplasmic inclusion bodies and multiple syncytial cells were found throughout the parenchymal tissue, both reacting clearly positive with antibodies against canine distemper virus (CDV) antigen. Phylogenetic analysis based on a 388 nucleotide (nt) fragment of the CDV phosphoprotein (P) gene revealed that the pack was infected with a CDV variant most closely related to Tanzanian variants, including those obtained in 1994 during a CDV epidemic in the Serengeti National Park and from captive African wild dogs in the Mkomazi Game Reserve in 2000. Phylogenetic analysis of a 335-nt fragment of the fusion (F) gene confirmed that the pack in 2007 was infected with a variant most closely related to one variant from 1994 during the epidemic in the Serengeti National Park from which a comparable fragment is available. Screening of tissue samples for concurrent infections revealed evidence of canine parvovirus, Streptococcus equi subsp. ruminatorum and Hepatozoon sp. No evidence of infection with Babesia sp. or rabies virus was found. Possible implications of concurrent infections are discussed. This is the first molecular characterisation of CDV in free-ranging African wild dogs and only the third confirmed case of fatal CDV infection in a free-ranging pack.

  9. Retroperitoneal unicentric Castleman's disease (giant lymph node hyperplasia: case report

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    Jaques Waisberg

    Full Text Available CONTEXT AND OBJECTIVE: Castleman's disease, or giant lymph node hyperplasia, is a rare disorder of the lymphoid tissue that causes lymph node enlargement. It is considered benign in its localized form, but aggressive in the multicentric type. The definitive diagnosis is based on postoperative pathological findings. The aim here was to describe a case of retroperitoneal unicentric Castleman's disease in the retroperitoneum. CASE REPORT: A 61-year old white male with weight loss and listlessness presented with moderate arterial hypertension and leukopenia. Abdominal tomography revealed a 5 x 4 x 5 cm oval mass of low attenuation, with inner calcification and intense enhancement on intravenous contrast, located in the retroperitoneal region, between the left kidney and the aorta, at the renal hilus. Exploratory laparotomy revealed a non-pulsatile solid oval mass situated in the retroperitoneum, adjacent to the left renal hilus. The retroperitoneal lesion was removed in its entirety. Examination of frozen samples revealed benign lymph node tissue and histopathological examination of the surgical sample revealed hyaline-vascular giant lymph node hyperplasia (Castleman's disease. The patient was discharged on the 12th day without significant events. Two months after the operation, the patient was readmitted with severe cardiac insufficiency, acute renal failure and bronchopneumonia, which progressed to acute respiratory insufficiency, sepsis and death.

  10. Measles outbreak in Macedonia: epidemiological, clinical and laboratory findings and identification of susceptible cohorts.

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    Irena T Kondova

    Full Text Available OBJECTIVES: Despite a 92-99% national vaccination coverage since 2000, the former Yugoslav Republic of Macedonia experienced a large measles outbreak between 2010 and 2011. Here we investigate the characteristics of patients hospitalized during this outbreak at the Clinic of Infectious Diseases in Skopje. METHODS: Epidemiological, clinical and laboratory data of 284 measles patients, including 251 from Skopje (43.80% of the 573 reported cases and 33 from elsewhere in Macedonia were collected. RESULTS: The most affected age groups were children up to 4 years of age and adolescents/adults of 15 years and older. Most patients were unvaccinated (n=263, 92.61% and many had non-Macedonian nationalities (n=156, 54.93% or belonged to the Roma ethnicity (n=73, 25.70%. Bronchopneumonia and diarrhea were the most common complications. Eighty-two out of 86 tested patients (95.35% had measles-specific IgM antibodies. The outbreak was caused by the measles variant D4-Hamburg. CONCLUSIONS: The epidemic identified pockets of susceptibles in Skopje and indicated that additional vaccination opportunities in particular for people with non-Macedonian nationality and traveler communities are warranted to ensure efficient measles control in Macedonia. The high attack rate among children of less than 1 year suggests that vaccination before 12 months of age should be considered in high risk settings.

  11. Neospora caninum: the First Demonstration of the Enteroepithelial Stages in the Intestines of a Naturally Infected Dog. (United States)

    Kul, O; Atmaca, H T; Anteplioglu, T; Ocal, N; Canpolat, S


    A 1.5-month-old Kangal breed puppy from a dairy cattle farm died after showing severe diarrhoea and incoordination. Necropsy examination revealed multifocal pulmonary consolidation and necrosis and fibrinohaemorrhagic enteritis. Microscopically, there was necrotic and purulent bronchopneumonia, myocarditis and non-purulent encephalitis. In the jejunum and ileum there was villous atrophy and crypt hyperplasia with oocyst-like and schizont-like structures in the epithelia. Immunohistochemically, Neospora caninum antigen was detected in association with the intestinal protozoal structures, degenerative neurons and areas of necrosis in the lungs and heart. Polymerase chain reaction confirmed that the organism was N. caninum and not Toxoplasma gondii. The seroprevalence for N. caninum was 74.2% (49/66 animals) for the cattle and 57.1% (4/7 animals) for dogs on this farm. This report documents fatal systemic neosporosis and enteroepithelial stages of N. caninum in a naturally infected puppy. To the authors' knowledge, this is the first definition of intestinal neosporosis in a naturally infected dog as well as the first evidence of fatal canine neosporosis in Turkey.

  12. Chronic health effects of sulphur mustard exposure with special reference to Iranian veterans

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    B Balali-Mood


    Full Text Available The widespread use of sulphur mustard (SM as an incapacitating chemical warfare agent in the past century has proved its long-lasting toxic effects. It may also be used as a chemical terrorist agent. Therefore, all health professionals should have sufficient knowledge and be prepared for any such chemical attack. SM exerts direct toxic effects on the eyes, skin, and respiratory tissue, with subsequent systemic action on the nervous, immunological, haematological, digestive, and reproductive systems. SM is an alkylating agent that affects DNA synthesis, and, thus, delayed complications have been seen since the First World War. Cases of malignancies in the target organs, particularly in haematopoietic, respiratory, and digestive systems, have been reported. Important delayed respiratory complications include chronic bronchitis, bronchiectasis, frequent bronchopneumonia, and pulmonary fibrosis, all of which tend to deteriorate with time. Severe dry skin, delayed keratitis, and reduction of natural killer cells with subsequent increased risk of infections and malignancies are also among the most distressing long-term consequences of SM intoxication. However, despite a lot of research over the past decades on Iranian veterans, there are still major gaps in the SM literature. Immunological and neurological dysfunction, as well as the relationship between SM exposure and mutagenicity, carcinogenicity, and teratogenicity are important fields that require further studies, particularly on Iranian veterans with chronic health effects of SM poisoning. There is also a paucity of information on the medical management of acute and delayed toxic effects of SM poisoning—a subject that greatly challenges health care specialists.

  13. Pasteurella multocida and bovine respiratory disease. (United States)

    Dabo, S M; Taylor, J D; Confer, A W


    Pasteurella multocida is a pathogenic Gram-negative bacterium that has been classified into three subspecies, five capsular serogroups and 16 serotypes. P. multocida serogroup A isolates are bovine nasopharyngeal commensals, bovine pathogens and common isolates from bovine respiratory disease (BRD), both enzootic calf pneumonia of young dairy calves and shipping fever of weaned, stressed beef cattle. P. multocida A:3 is the most common serotype isolated from BRD, and these isolates have limited heterogeneity based on outer membrane protein (OMP) profiles and ribotyping. Development of P. multocida-induced pneumonia is associated with environmental and stress factors such as shipping, co-mingling, and overcrowding as well as concurrent or predisposing viral or bacterial infections. Lung lesions consist of an acute to subacute bronchopneumonia that may or may not have an associated pleuritis. Numerous virulence or potential virulence factors have been described for bovine respiratory isolates including adherence and colonization factors, iron-regulated and acquisition proteins, extracellular enzymes such as neuraminidase, lipopolysaccharide, polysaccharide capsule and a variety of OMPs. Immunity of cattle against respiratory pasteurellosis is poorly understood; however, high serum antibodies to OMPs appear to be important for enhancing resistance to the bacterium. Currently available P. multocida vaccines for use in cattle are predominately traditional bacterins and a live streptomycin-dependent mutant. The field efficacy of these vaccines is not well documented in the literature.

  14. Evidence of injury caused by gas bubbles in a live marine mammal: barotrauma in a California sea lion Zalophus californianus. (United States)

    Van Bonn, W; Montie, E; Dennison, S; Pussini, N; Cook, P; Greig, D; Barakos, J; Colegrove, K; Gulland, F


    A yearling male California sea lion Zalophus californianus with hypermetric ataxia and bilateral negative menace reflexes was brought to The Marine Mammal Center, Sausalito, California, U.S.A., in late 2009 for medical assessment and treatment. The clinical signs were due to multiple gas bubbles within the cerebellum. These lesions were intraparenchymal, multifocal to coalescing, spherical to ovoid, and varied from 0.5 to 2.4 cm diameter. The gas composed 21.3% of the total cerebellum volume. Three rib fractures were also noted during diagnostic evaluation and were presumed to be associated with the gas bubbles in the brain. The progression of clinical signs and lesion appearance were monitored with magnetic resonance imaging, cognitive function testing and computed tomography. Gas filled voids in the cerebellum were filled with fluid on follow up images. Clinical signs resolved and the sea lion was released with a satellite tag attached. Post release the animal travelled approximately 75 km north and 80 km south of the release site and the tag recorded dives of over 150 m depth. The animal re-stranded 25 d following release and died of a subacute bronchopneumonia and pleuritis. This is the first instance of clinical injury due to gas bubble formation described in a living pinniped and the first sea lion with quantifiable cerebellar damage to take part in spatial learning and memory testing.

  15. Radiologic Review of an Outbreak of the Pandemic (H1N1) 2009 Virus Infection at a University Hospital in Seoul, Korea

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    Choi, Seung Hee; Kang, Eun Young; Kim, Yoon Kyung; Woo, Ok Hee; Yong, Hwan Seok; Oh, Yu Whan [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Jang Su [Dept. of Laboratory Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)


    To assess the frequency of radiologic abnormalities and investigate the radiologic findings of patients with a pandemic (H1N1) 2009 virus infection at a University hospital in Seoul, Korea. In November 2009, 9,427 patients were tested for pandemic (H1N1) 2009 virus and 3,849 (41%) were positive. Among them, only 338 (9%) underwent chest radiographs and 13 (0.3%) received chest CT. Two radiologists retrospectively reviewed all the radiologic images. Among the 338 patients, 287 (85%) were normal and 51 (15%) showed abnormalities. The frequency of abnormalities was significantly higher in children (41/212=19%) than in adults (10/126=8%) (p = 0.005). Of them, 42 (82%) patients had airspace pneumonia, whereas the remaining patients showed a bronchopneumonia pattern. Unilateral (82%) involvement was more common than bilateral (18%) involvement. Among patients who received chest CT, 12 (92%) showed abnormalities, with bilateral (67%) and random (75%) involvement being more common. Ground-glass opacity (67%) and centrilobular nodules (58%) were the more common CT findings. Only a small number of patients were critically ill enough to undergo further radiologic evaluation as a result of pandemic (H1N1) 2009 virus infection, and most patients had normal chest radiographs. Unilateral airspace pneumonia was the most common abnormality in patients infected with pandemic (H1N1) 2009 virus.

  16. Botulinum toxin A for trismus in cephalic tetanus

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    Luiz Augusto F. Andrade


    Full Text Available Cephalic tetanus is a localized form of tetanus. As in generalized forms , trismus is a prominent feature of the disease, leading to considerable difficulty in feeding, swallowing of the saliva and mouth hygiene. These difficulties often precede respiratory problems and aspiration bronchopneumonia is a frequent life-threatening complication. Muscle relaxants other than curare drugs may show a limited benefit for relieving trismus. Tetanospasmin, the tetanic neurotoxin, and botulinum toxin share many similarities, having a closely related chemical structure, an origin from related microorganisms (Clostridium tetani and Clostridium botulinum, respectively, and presumably, the same mechanisms of action in the neuron. The difference between the two lies in their peculiar neurospecificity, acting in different neurons. Injection of minute doses of botulinum toxin in the muscles involved in focal dystonias or other localized spastic disorders have proved to be very effective in these conditions. We describe the use of botulinum toxin A in the successful treatment of trismus in a patient suffering from cephalic tetanus. We believe that this form of treatment may be of value in lowering the risk of pulmonary complications in tetanic patients.

  17. August 2012 imaging case of the month

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    Gotway MB


    Full Text Available No abstract available. Article truncated at 150 words. Clinical History: A 48-year-old non-smoking man presented with a history of slowly progressive shortness of breath and recent onset of a headache. Frontal chest radiography (Figure 1 was performed.Figure 1: Frontal chest radiography shows normal cardiomediastinal contours with bilateral peri- and infrahilar predominant ground-glass opacity with a background of linear and reticular abnormalities.Which of the differential diagnostic considerations listed below is the most likely consideration for the chest radiographic abnormality?1.Pneumococcal pneumonia 2.Lung carcinoma3.Idiopathic pulmonary fibrosis4.Pulmonary alveolar proteinosis5.Miliary tuberculosisCorrect!Answer: 4. Pulmonary alveolar proteinosisThe frontal chest radiograph shows bilateral increased lung attenuation consisting of ground-glass opacity and a background of linear and reticular abnormalities. Pneumococcal pneumonia is a possibility, but this infection most commonly presents either with an air-space pneumonia pattern [homogeneous lung opacity with air bronchograms extending towards the pleural surface] or with a bronchopneumonia pattern [patchy …

  18. Ocorrência de pneumonia associada à infecção por Mannheimia haemolytica em ovinos de Minas Gerais Occurrence of pneumonia associated to infection by Mannheimia haemolytica in sheep of Minas Gerais

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    Marina Rios de Araújo


    animals were not medicated and found dead. Grossly, the pulmonary findings were similar in all sheep. The pulmonary cranial lobes and the ventral portion of caudal lobes were consolidated and purulent exsudate streamed out of the airways. In the parenchyma of the cranial lobes there were white slightly prominent multifocal to coalescent areas with 0.2 to 0.5cm in diameter intercalated with dark red areas. Consolidated lesions occupied 70 to 80% of the lungs. Fibrinous pleuritis was observed in sheep 1, 2 and 3. Microscopically, the findings were fibrinopurulent bronchopneumonia with intense hyperemia, areas with intra-alveolar hemorrhage and thickening of interlobular septa with numerous neutrophils, cellular rests and scattering fibrin. Multifocal areas with liquefaction necrosis containing numerous bacterial colonies were observed in sheep 1, 2 and 3. In the cranial lobes of these sheep, there were areas with degenerated neutrophils forming clusters of basophilic cells with alongated nuclei ("oat cells" associated with bacterial colonies. The histological findings were characteristic of pneumonia caused by Mannheimia (M. haemolytica. Samples of the cranial lobes were sent for bacterial culture, and M. haemolytica was isolated and identified in all animals. This is the first report correlating pathological findings and the isolation of M. haemolytica as cause of bronchopneumonia in sheep in the country.

  19. 20例海洛因成瘾死亡者组织病理变化观察%Observation of Histopathological Changes in Heroin-addicts with 20 Cases

    Institute of Scientific and Technical Information of China (English)

    李利华; 赵永和; 姚宏; 冯忠堂; 刑豫明; 杨润祥


    对20例海洛因成瘾死亡者尸体进行系统的尸体解剖研究和病理组织研究.结果表明:体表注射痕迹、纹身、色素沉着、消瘦和自伤疤痕常提示吸毒行为;各器官并发慢性感染疾病,主要表现为支气管肺炎、肺脓肿、慢性肝炎、肝硬化、脾淋巴结及淋巴组织反应性增生、感染性静脉炎,肾上腺、甲状腺呈慢性炎症改变,弥漫性神经细胞变性、坏死等.研究病例中50%直接死因为海洛因过量急性中毒,40%死于肺部感染性疾病,10%死于外来暴力.%The series postmortemautopsy examination and histopat hology research in 20 cases heroin-addicts are accomplished. Research result s show that injection marks, tattoo,skin pigmentation,emaciation and harmed-self scar usua1ly point out addiction behavior: Various chronic infective diseases of organs are complicated by heroi n addiction, and the main complicated diseases are bronchopneumonia, lung absces s,chronic hepatitis,liver cirrhosis, reactive follicular hyperplasia in lymphn ode,spleen,infective angiitis, chronic inflammation in suprarenal , thyoadennitis overflowi ng degeneration and necrosis of neurocytes etc. in 20 cases, 50% cases died of ac ute heroin poison, 40% cases died of chronic infective diseases, and l0% died from violent injury.

  20. Clinical features of severe malnutrition at the pediatric ward of Dr. Pirngadi Hospital Medan. (United States)

    Barus, S T; Rani, R; Lubis, N U; Hamid, E D; Tarigan, S


    A retrospective study on severe malnutrition concerning children hospitalized at the Pediatric ward of Dr. Pirngadi Hospital, Medan from January 1 to December 31, 1988 was conducted. Patients less than five years old were included in this study. The purpose of this study was to know the incidence of severe malnutrition, its symptoms and signs, the immunization status, feeding pattern and socio-economic factors. Out of the 3370 hospitalized patients, 2453 (72.78%) were children under five years old. Of these, 312 (12%) suffered from severe malnutrition. It consisted of marasmus 131 (41.9%), marasmic kwashiorkor 94 (30.1%) and kwashiorkor 87 (27.8%). The highest incidence was found in the age group of 0-2 years (58%). Clinical manifestation of marasmus were old man face (131 or 100%), muscular hypotrophy (118 or 71.9%) and decreased subcutaneous fat (116 or 71.1%) in marasmic kwashiorkor children 46 or 50% had their hair easily picked out, 45 or 46.3% showed hyperpigmentation and 48 or 52% had pretibial edema in the kwashiorkor group 29 or 63% had moon face, 52 or 60.4% showed crazy pavement dermatosis, 77 or 51.3% had hepatomegaly and 87 or 48% pretebial edema. Moon face was seen in 29 (63%), crazy Pavement Dermatosis in 52 (60.4%), hepatomegaly in 77 (51.3%), and pretebial edema in 87 (48%) of kwashiorkor cases. The accompanying diseases were mostly diarrhea (95%) and bronchopneumonia (22%). Immunization status showed that BCG comprised 50.6%, while DPT III and OPV III in 13.7% and 10.5% respectively and measles only 0.64%. More than half (59.6%) of them were breast-fed up to 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. PCR assay detects Mannheimia haemolytica in culture-negative pneumonic lung tissues of bighorn sheep (Ovis canadensis) from outbreaks in the western USA, 2009-2010. (United States)

    Shanthalingam, Sudarvili; Goldy, Andrea; Bavananthasivam, Jegarubee; Subramaniam, Renuka; Batra, Sai Arun; Kugadas, Abirami; Raghavan, Bindu; Dassanayake, Rohana P; Jennings-Gaines, Jessica E; Killion, Halcyon J; Edwards, William H; Ramsey, Jennifer M; Anderson, Neil J; Wolff, Peregrine L; Mansfield, Kristin; Bruning, Darren; Srikumaran, Subramaniam


    Mannheimia haemolytica consistently causes severe bronchopneumonia and rapid death of bighorn sheep (Ovis canadensis) under experimental conditions. However, Bibersteinia trehalosi and Pasteurella multocida have been isolated from pneumonic bighorn lung tissues more frequently than M. haemolytica by culture-based methods. We hypothesized that assays more sensitive than culture would detect M. haemolytica in pneumonic lung tissues more accurately. Therefore, our first objective was to develop a PCR assay specific for M. haemolytica and use it to determine if this organism was present in the pneumonic lungs of bighorns during the 2009-2010 outbreaks in Montana, Nevada, and Washington, USA. Mannheimia haemolytica was detected by the species-specific PCR assay in 77% of archived pneumonic lung tissues that were negative by culture. Leukotoxin-negative M. haemolytica does not cause fatal pneumonia in bighorns. Therefore, our second objective was to determine if the leukotoxin gene was also present in the lung tissues as a means of determining the leukotoxicity of M. haemolytica that were present in the lungs. The leukotoxin-specific PCR assay detected leukotoxin gene in 91% of lung tissues that were negative for M. haemolytica by culture. Mycoplasma ovipneumoniae, an organism associated with bighorn pneumonia, was detected in 65% of pneumonic bighorn lung tissues by PCR or culture. A PCR assessment of distribution of these pathogens in the nasopharynx of healthy bighorns from populations that did not experience an all-age die-off in the past 20 yr revealed that M. ovipneumoniae was present in 31% of the animals whereas leukotoxin-positive M. haemolytica was present in only 4%. Taken together, these results indicate that culture-based methods are not reliable for detection of M. haemolytica and that leukotoxin-positive M. haemolytica was a predominant etiologic agent of the pneumonia outbreaks of 2009-2010.

  2. Mycoplasma ovipneumoniae can predispose bighorn sheep to fatal Mannheimia haemolytica pneumonia. (United States)

    Dassanayake, Rohana P; Shanthalingam, Sudarvili; Herndon, Caroline N; Subramaniam, Renuka; Lawrence, Paulraj K; Bavananthasivam, Jegarubee; Cassirer, E Frances; Haldorson, Gary J; Foreyt, William J; Rurangirwa, Fred R; Knowles, Donald P; Besser, Thomas E; Srikumaran, Subramaniam


    Mycoplasma ovipneumoniae has been isolated from the lungs of pneumonic bighorn sheep (BHS). However experimental reproduction of fatal pneumonia in BHS with M. ovipneumoniae was not successful. Therefore the specific role, if any, of M. ovipneumoniae in BHS pneumonia is unclear. The objective of this study was to determine whether M. ovipneumoniae alone causes fatal pneumonia in BHS, or predisposes them to infection by Mannheimia haemolytica. We chose M. haemolytica for this study because of its isolation from pneumonic BHS, and its consistent ability to cause fatal pneumonia under experimental conditions. Since in vitro culture could attenuate virulence of M. ovipneumoniae, we used ceftiofur-treated lung homogenates from pneumonic BHS lambs or nasopharyngeal washings from M. ovipneumoniae-positive domestic sheep (DS) as the source of M. ovipneumoniae. Two adult BHS were inoculated intranasally with lung homogenates while two others received nasopharyngeal washings from DS. All BHS developed clinical signs of respiratory infection, but only one BHS died. The dead BHS had carried leukotoxin-positive M. haemolytica in the nasopharynx before the onset of this study. It is likely that M. ovipneumoniae colonization predisposed this BHS to fatal infection with the M. haemolytica already present in this animal. The remaining three BHS developed pneumonia and died 1-5 days following intranasal inoculation with M. haemolytica. On necropsy, lungs of all four BHS showed lesions characteristic of bronchopneumonia. M. haemolytica and M. ovipneumoniae were isolated from the lungs. These results suggest that M. ovipneumoniae alone may not cause fatal pneumonia in BHS, but can predispose them to fatal pneumonia due to M. haemolytica infection.

  3. Clinical features and phylogenetic analysis of Coxsackievirus A9 in Northern Taiwan in 2011

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    Huang Yi-Chuan


    Full Text Available Abstract Background Coxsackievirus A9 (CA9 was one of the most prevalent serotype of enteroviral infections in Taiwan in 2011. After several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of CA9 infections. Our study explores and deepens the current understanding of CA9. Methods We analyzed the clinical presentations of 100 culture-proven CA9-infected patients in 2011 by reviewing their medical records and depicted the CA9 phylogenetic tree. Results Of the 100 patients with culture-proven CA9 infections, the mean (SD age was 4.6 (3.4 years and the male to female ratio was 1.9. For clinical manifestations, 96 patients (96% had fever and the mean (SD duration of fever was 5.9 (3.4 days. Sixty one patients (61% developed a skin rash, and the predominant pattern was a generalized non-itchy maculopapular rash without vesicular changes. While most patients showed injected throat, oral ulcers were found in only 19 cases (19%, among whom, 6 were diagnosed as herpangina. Complicated cases included: aseptic meningitis (n=8, bronchopneumonia (n=6, acute cerebellitis (n=1, and polio-like syndrome (n=1. Phylogenetic analysis for current CA9 strains is closest to the CA9 isolate 27-YN-2008 from the border area of mainland China and Myanmar. Conclusions The most common feature of CA9 during the 2011 epidemic in Taiwan is generalized febrile exanthema rather than herpangina or hand, foot, and mouth disease. Given that prolonged fever and some complications are possible, caution should be advised in assessing patients as well as in predicting the clinical course.


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    Sathikumar M


    Full Text Available BACKGROUND In the present study, aetiological factors leading to death from burns; pattern of burns; the environment in which the incident occurs, depth and percentage of burns, effect of clothing on the distribution and extent of burns sustained. The changes occurring in the internal organs like lungs and kidneys of victims died of burns and period of survival after sustaining burns are studied in detail. With this background, the lungs and kidneys of the victims died of burns were subjected for detailed histopathological examination and the various pathological changes occurred in them are studied. MATERIALS AND METHODS The study was conducted at Government Medical College, Kozhikode. During the period of 1 year, 60 cases of death due to burn from the fire were studied. RESULTS It was noted that majority of lung specimen showed histopathological changes like alveolar oedema and congestion, bronchiolar congestion and haemorrhage, interstitial oedema, haemorrhage, congestion, and inflammation. The kidneys showed acute tubular necrosis and haemorrhage, glomerular haemorrhage and oedema, interstitial necrosis, haemorrhage and congestion as histopathological changes. DISCUSSION AND CONCLUSION From this study at different periods of survival in burns of two organs, the histopathological changes of lungs and kidneys are more prominent. When the period of survival increased, i.e., these organs undergoes severe and very severe degree of changes. Most of the subject died of acute pulmonary oedema, bronchopneumonia, renal failure, and septicaemia in late period of survival. Hence, on conclusion from the study that the lungs and kidneys are two internal organs, which show constant histopathological changes in cases of death due to burns irrespective of the period of survival and these organs are more important in determining the cause of death.

  5. Mathematical model of mean age, mean arsenic dietary dose and age-specific prevalence rate from endemic chronic arsenic poisoning: a human toxicology study

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    Zald' ivar, R.; Ghai, G.L.


    The aim of this investigation was to develop a mathematical model of mean age, mean arsenic dietary dose, and age-specific prevalence rate for endemic chronic arsenic poisoning. Data on mean age (years), mean arsenic dietary dose (mg/kg body weight/day), and age-specific prevalence rate per 100,000 population for endemic chronic arsenic poisoning in Antofagasta Commune, northern Chile, for the 1968 to 1971 period, were collected. Endemic chronic arsenic poisoning means here chronic arsenical dermatosis associated with marked or sever symptoms (or signs) of chronic arsenic poisoning (chronic diarrhea, hepatic cirrohsis, chronic bronchitis, bronchiectasis, recurrent broncho-pneumonia, cardiomegaly, systemic occlusive arterial disease, cerebral thrombosis, etc.). There was a strong positive correlation between age-specific pevalence rate per 100,000 population and mean arsenic dose (r = + 0.9593) and a negative correlation between prevalence rate and mean age (r = 0.8789). These findings show that the prevalence rate declines with the advancing age and increases with the increase of arsenic dose. A multiple linear regression model E(y) = alpha + beta X1 + gamma X2, where y represents the age-specific prevalence rate per 100,000 population, X1 the mean arsenic dose, and X2 the mean age, was fitted to the data. The estimates of the parameters (alpha, beta, and gamma) were obtained by minimizing the residual sum of squares sigma(y - alpha - beta X1 - gamma X2)2. The following multiple linear regression equation was obtained: Y = 202.161 + 8452.455 X1 - 2.394 X2. Of the total variability in the prevalence rate, 96.22 percent was accounted for by the multiple regression.


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    Fischer 344 rats were exposed to 0.0, 0.4, 1.4, or 4.0 ppm acrolein for 62 days. The major objective of the study was to relate the results of a series of pulmonary function tests to biochemical and pathological alterations observed in the lung. Cytological and reproductive potential endpoints were also assessed after acrolein exposure. Rats were exposed to acrolein for 6 hours/day, 5 days/week for 62 days. Mortality was observed only in the 4.0 ppm chamber where 32 of 57 exposed males died; however, none of the 8 exposed females died. Most of the mortality occurred within the first 10 exposure days. Histologic examination indicated that the animals died of acute bronchopneumonia. The surviving males and females exposed to 4.0 ppm acrolein gained weight at a significantly slower rate than control animals. The growth of both sexes in the 0.4 and 1.4 ppm groups was similar to that of their respective controls. Histopathologic examination of animals after 62 days of exposure revealed bronchiolar epithelial necrosis and sloughing, bronchiolar edema with macrophages, and focal pulmonary edema in the 4.0 ppm group. These lesions were, in some cases, associated with edema of the trachea and peribronchial lymph nodes, and acute rhinitis which indicated an upper respiratory tract effect of acrolein. Of particular interest was the variability of response between rats in the 4.0 ppm group, some not affected at all while others were moderately affected. Intragroup variability in toxicity was also apparent in the 1.4 ppm exposure group where only 3 of 31 animals examined had lesions directly related to acrolein exposure. Extra respiratory organs appeared unaffected.

  7. REVIEW paper: mare reproductive loss syndrome. (United States)

    Sebastian, M M; Bernard, W V; Riddle, T W; Latimer, C R; Fitzgerald, T D; Harrison, L R


    An epidemic of early fetal loss (EFL), late fetal loss (LFL), fibrinous pericarditis, and unilateral uveitis which occurred during the spring of 2001, are together now known as the mare reproductive loss syndrome (MRLS). A similar epidemic with less intensity was reported during the same period of time from southern Ohio, West Virginia, and Tennessee. The same syndrome with lesser intensity recurred in 2002. The estimated economic loss from the syndrome in 2001 and 2002 together was approximately $500 million. Both EFL and LFL were characterized by the absence of specific clinical signs in aborting mares. Nonhemolytic Streptococcus spp. and Actinobacillus spp. accounted for 65% of the organisms isolated from fetuses submitted for a postmortem during the MRLS period in 2001 and 2002. The pathologic findings in fetoplacental units of LFL included bronchopneumonia and funisitis, and there were no findings in EFL. Epidemiologic studies conducted in 2001 suggested an association between the presences of eastern tent caterpillars (ETC) in pastures with MRLS. Experimental studies in pregnant mares by exposure to ETC, or administration by stomach tube or with feed material, reproduced EFL and LFL. Similar experimental studies in mouse, rats, and goats with ETC were unsuccessful. Currently, 2 hypotheses are proposed for MRLS. One hypothesis proposes that an ETC-related toxin with secondary opportunistic bacterial invasion of the fetus leads to MRLS. The second hypothesis suggests that a breach of gastrointestinal mucosal integrity by hairs of ETC leads to a bacteremia and results in MRLS. In 2004, a similar equine abortion storm was reported from Australia and caterpillar exposure was identified as a risk factor for the abortion. In 2006, the syndrome was observed in Florida and New Jersey.

  8. Multidrug-resistant endemic clonal strain of Candida auris in India. (United States)

    Chowdhary, A; Anil Kumar, V; Sharma, C; Prakash, A; Agarwal, K; Babu, R; Dinesh, K R; Karim, S; Singh, S K; Hagen, F; Meis, J F


    Candida auris is a recently described rare agent of fungemia. It is notable for its antifungal resistance. A total of 15 C. auris isolates, originating from seven cases of fungemia, three cases of diabetic gangrenous foot, and one case of bronchopneumonia from a tertiary care hospital in south India, were investigated. All of the 15 isolates were identified by sequencing and 14 of these along with 12 C. auris isolates previously reported from two hospitals in Delhi, north India, two each from Japan and Korea were genotyped by amplified fragment length polymorphism (AFLP). In vitro antifungal susceptibility testing (AFST) was done by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. Candida auris isolates were misidentified as Candida haemulonii by VITEK. All were resistant to fluconazole [geometric mean minimum inhibitory concentration (MIC) 64 μg/ml] and 11 isolates were resistant to voriconazole (MIC ≥1 μg/ml). Forty-seven percent of the C. auris isolates were resistant to flucytosine (MIC ≥64 μg/ml) and 40% had high MIC (≥1 μg/ml) of caspofungin. Breakthrough fungemia developed in 28.6% of patients and therapeutic failure in 4 (66.7%) patients. Interestingly, the 26 Indian C. auris isolates from north and south India were clonal and phenotypically and genotypically distinct from Korean and Japanese isolates. The present study demonstrates that C. auris is a potential emerging pathogen that can cause a wide spectrum of human mycotic infections. The prevalence of a C. auris endemic clonal strain resistant to azoles and other antifungals in Indian hospitals with high rates of therapeutic failure in cases of fungemia is worrisome.

  9. Lesões pulmonares provocadas pela nicotina por via subcutânea em ratos Influence of subcutaneous nicotine in the lungs of rats

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    Aldo da Cunha Medeiros


    Full Text Available OBJETIVO: Estudo com o objetivo de observar a influência da nicotina, aplicada pela via subcutânea, em pulmões de ratos. MÉTODOS: Foram utilizados 20 ratos Wistar pesando 235± 35g, separados aleatoriamente em 2 grupos iguais. O grupo I (n=10 recebeu nicotina na dose de 2 mg/Kg/dia pela via subcutânea durante 20 dias e o grupo II (n=10 recebeu placebo pela mesma via de administração. RESULTADOS: Os resultados mostraram que no grupo I ocorreu broncopneumonia em 3 (30% ratos, leucocitose alveolar em 10 (100% e leucocitose septal em 7 (70%. Atelectasia foi encontrada em 2 (20%. Transformados em escores, os dados totalizaram 52 pontos. Os escores das alterações observadas nos pulmões do grupo II atingiram 11 pontos (pOBJECTIVE: The aims of this study were to determine and quantify the influence of nicotine, applied subcutaneously, in the lungs of rats. METHODS: Twenty Wistar rats weighing 235±35g were randomly separated in two groups. The group I (n=10 received nicotine ( 2 mg/Kg body mass/day during 20 days and the group II (n=10 received placebo subcutaneously. RESULTS: The results illustrate that in the group I resulted bronchopneumonia in 3 (30% rats, alveolar leucocitosis in 10 (100%, septal leucocitosis in 7 (70% and atelectasia was found in 2 (20%. Transformed in scores, the data totalized 52 points. The scores of the lesions observed in the lungs of group II rats reached 11 points (p <0,05. CONCLUSION: These findings indicate and conclude that the use of nicotine subcutaneously can be implicated in significant lung lesions in rats, when compared with controls.

  10. Coexistence of mixed phenotype Creutzfeldt-Jakob disease, Lewy body disease and argyrophilic grain disease plus histological features of possible Alzheimer's disease: a multi-protein disorder in an autopsy case. (United States)

    Fernández-Vega, Iván; Ruiz-Ojeda, Javier; Juste, Ramon A; Geijo, Maria; Zarranz, Juan Jose; Sánchez Menoyo, Jose Luis; Vicente-Etxenausia, Ikerne; Mediavilla-García, Jennifer; Guerra-Merino, Isabel


    We report hereby an autopsy case of sporadic mixed phenotype CJD without hereditary burden and a long-term clinical course. An 80-year old man was diagnosed with mild cognitive impairment 27 months before death, caused by bronchopneumonia and severe respiratory impairment. During this time, the patient developed gradual mental deterioration, some sleeping problems and myoclonus. Other clinical manifestations were progressive gait problems, language deterioration, presence of primitive reflexes and irritability. In keeping with those symptoms, a rapidly evolving dementia was clinically suspected. Cerebrospinal fluid test for 14-3-3 protein was negative. However, an abnormal EEG and MRI at end-stage of disease were finally consistent with CJD. Post-mortem examination revealed a massive cortical neuronal loss with associated reactive astrocytosis, also evident in the white matter. Diffuse spongiform changes involving some basal ganglia, especially medial thalamus, some troncoencephalic nuclei, mainly inferior olivary nucleus and the molecular layer of the cerebellum were seen. Immunorreactive deposits for anti-prion protein antibody were present at different areas of the CNS. Additionally, Lewy bodies were observed at the brainstem and amygdala. Furthermore, argirophilic grains together with oligodendroglial coiled bodies and pre-tangle inclusions in the neurons from the limbic system containing hyperphosphorylated 4R tau were noted. To the best of our knowledge, this is the first case of CJD combined with Lewy body disease and argirophilic grain disease. Furthermore, we believe this case is an extremely rare combination of MM2-cortical-type and MM2-thalamic-type sporadic CJD (sCJD), which explains the broad spectrum of MM2-type sCJD findings and symptoms. Moreover, histological features of possible Alzheimer's disease were also reported.

  11. An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: epidemiology and diagnostic and genetic aspects. (United States)

    Tsai, Huey-Pin; Huang, Sheng-Wen; Wu, Feng-Ling; Kuo, Pin-Hwa; Wang, Shih-Min; Liu, Ching-Chuan; Su, Ih-Jen; Wang, Jen-Ren


    In 2006, an outbreak of aseptic meningitis was noted in Taiwan. From January to October 2006, a total of 3283 specimens collected from patients with viral infection, including 173 cerebrospinal fluid (CSF) samples, were examined for virus isolation and identification. Overall, 339 enterovirus (EV)-positive cases were identified by virus culture: echovirus 18 (E18) formed the majority (27.4 %, 93 cases), followed by coxsackievirus B2 (13.8 %, 47 cases) and coxsackievirus A2 (10.8 %, 37 cases). The manifestations of the 93 E18 cases were aseptic meningitis (44.1 %), viral exanthema (23.6 %), acute tonsillitis (15.1 %), acute pharyngitis (14.0 %), acute gastritis (11.8 %), herpangina (7.5 %) and bronchopneumonia (5.3 %). Of 107 E18 isolates identified, 100, 62.5 and 19 % were obtained following culture in RD, MRC-5 and A549 cells, respectively. E18 was identified most frequently from throat swabs (67.2 %) and less frequently from stool samples (15.9 %) and CSF (16.8 %). The detection rate of E18 was 78.2 % from CSF, 50 % from stool samples and 22.9 % from throat swabs. Phylogenetic relationships among the E18 strains were examined. Analysis of the partial VP1 gene showed 3.7-23.8 % variation in sequence compared with sequences from GenBank and, notably, the amino acid change V152S was detected in a protruding loop within the VP1 protein. These results indicate that a genetic variant of E18 was circulating and caused an outbreak of aseptic meningitis in Taiwan in 2006.


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    , pleural effusion and bronchopneumonia on chest radiogram are associated with DHF and DSS.

  13. Development and characterization of a caprine aerosol infection model of melioidosis.

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    Carl Soffler

    Full Text Available Infection with Burkholderia pseudomallei causes the disease melioidosis, which often presents as a serious suppurative infection that is typically fatal without intensive treatment and is a significant emerging infectious disease in Southeast Asia. Despite intensive research there is still much that remains unknown about melioidosis pathogenesis. New animal models of melioidosis are needed to examine novel aspects of pathogenesis as well as for the evaluation of novel therapeutics. The objective of the work presented here was to develop a subacute to chronic caprine model of melioidosis and to characterize the progression of disease with respect to clinical presentation, hematology, clinical microbiology, thoracic radiography, and gross and microscopic pathology. Disease was produced in all animals following an intratracheal aerosol of 10(4 CFU delivered, with variable clinical manifestations indicative of subacute and chronic disease. Bronchointerstitial pneumonia was apparent microscopically by day 2 and radiographically and grossly apparent by day 7 post infection (PI. Early lesions of bronchopneumonia soon progressed to more severe bronchointerstitial pneumonia with pyogranuloma formation. Extrapulmonary dissemination appeared to be a function of pyogranuloma invasion of pulmonary vasculature, which peaked around day 7 PI. Histopathology indicated that leukocytoclastic vasculitis was the central step in dissemination of B. pseudomallei from the lungs as well as in the establishment of new lesions. While higher doses of organism in goats can produce acute fatal disease, the dose investigated and resulting disease had many similarities to human melioidosis and may warrant further development to provide a model for the study of both natural and bioterrorism associated disease.

  14. Neospora caninum is a cause of perinatal mortality in axis deer (Axis axis). (United States)

    Basso, Walter; Moré, Gastón; Quiroga, Maria Alejandra; Balducchi, Diego; Schares, Gereon; Venturini, Maria Cecilia


    Neospora caninum is a worldwide distributed protozoan that may cause neuromuscular disease in dogs and reproductive failure in domestic and wild ruminants. One axis fawn (Axis axis) and four neonates from the same deer herd died at a zoo in Argentina within a four-month period. The fawn presented with dilatation of the anal sphincter at birth and incontinence, developed weakness and ataxia and died at 14 days of age. At necropsy, a mega formation of the distal large intestine was observed. Microscopically, non-suppurative encephalitis, suppurative bronchopneumonia, fibrin necrotic enteritis and degenerative changes in the liver were observed in hematoxilin and eosin-stained tissue sections, and thick-walled N. caninum-like cysts were observed in fresh brain samples. Serologic studies for N. caninum revealed an IFAT titer of 1:6400 in the fawn and 1:25, 1:400, 1:3200 and 1:6400 in the neonates. N. caninum DNA was detected in brain samples from the fawn and from one neonate by PCR, and the parasite was isolated in vitro from the fawn' brain after passage through gerbils (Meriones unguiculatus) and gamma-interferon knock-out mice. N. caninum DNA obtained from the fawn, neonate and isolated parasites showed the same microsatellite pattern. This suggests a common infection source for both animals. The diagnosis of N. caninum infection was confirmed, suggesting its association with perinatal mortality in captive axis deer. To the best of our knowledge, this is the first report of clinical disease associated to N. caninum infection in axis deer and of isolation of the parasite from this wild ruminant species.

  15. Forensic intoxication with clobazam: HPLC/DAD/MSD analysis. (United States)

    Proença, Paula; Teixeira, Helena; Pinheiro, João; Marques, Estela P; Vieira, Duarte Nuno


    Clobazam (Castillium, Urbanil), a benzodiazepine often used as an anxiolytic and in the treatment of epilepsy, is considered a relatively safe drug. The authors present a fatal case with a 49-year-old female, found dead at home. She had been undergoing psychiatric treatment and was a chronic alcoholic. The autopsy findings were unremarkable, except for multivisceral congestion, steatosis and a small piece of a plastic blister pack in the stomach. Bronchopneumonia, bronchitis and bronchiolitis were also diagnosed. Anhigh-performance liquid chromatography (HPLC)/diode array detector (DAD)/mass spectrometry detection (MSD) with electrospray method was developed in order to detect, confirm and quantify clobazam in the post-mortem samples. In the chromatographic separation, a reversed-phase column C18 (2.1 x 150 mm, 3.5 microm) was used with a mobile phase of methanol and water, at a 0.25 ml/min flow rate. Carbonate buffer (pH 10.5) and 20 microl of prazepam (100 microg/ml) as internal standard were added to the samples. A simple and reliable liquid-liquid extraction method for the determination of clobazam in post-mortem samples was described. Calibration curves for clobazam were performed in blood, achieving linearity between 0.01 and 10 microg/ml and a detection limit of 1.0 ng/ml. The clobazam concentration found in post-mortem blood was 3.9 microg/ml, higher than the reported therapeutic concentration (0.1-0.4 microg/ml). The simultaneous acquisition by photodiode array detection and mass spectrometry detection results allowed benzodiazepines to be identified with sufficient certainty. An examination of all the available information suggested that death resulted from respiratory depression due to clobazam toxicity.

  16. Aborto viral equino. Descripción anatomopatológica de dos casos ocurridos en la VIII Región, Chile Histopathological aspects of two cases of equine viral abortion in the VIII Region, Chile

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    A. RUIZ


    Full Text Available Se describen dos casos de aborto viral equino, un feto abortado al final de la gestación y el otro nacido y muerto 24 horas después, provenientes de un predio que presentó otros 6 abortos más en la temporada de partos del año 1996. En la necropsia de ambos se observó ictericia, hemorragias oral y nasal, hemorragias de los linfonódulos, congestión general, pleuritis serofibrinosa, edema pulmonar, bronconeumonía catarral en los lóbulos apicales, ascitis, esplecnomegalia, necrosis del hígado y nefrosis. La histopatología y microscopía electrónica revelaron la existencia de cuerpos de inclusión intranucleares de tipo A de Cowdry en células epiteliales del pulmón, hepatocitos y macrófagos del bazo. Estos antecedentes son semejantes a lo descrito en aborto viral herpético o rinoneumonitis equina.Two cases of equine viral abortion are described: one foetus which was miscarried at the end of the pregnancy and the other which was born and died 24 hs later. Both cases came from a farm that had had 6 mare miscarriages during the 1996 birth period. The following lesions were observed in the necropsy: icterus, oral and nasal haemorrhages, lymphoid haemorrhages, general congestion, serophibrinous pleuritis, lung oedema, catarrhs bronchopneumonia at the apical lobes, ascitis, enlarged spleen, liver necrosis and nephrosis. Histopathology and electron microscopy indicated the presence of intranuclear inclusion bodies Cowdry type A in the epithelial cells of the lung, hepatocytes and macrophages of the spleen. All of the lesions are similar to those described in equine viral abortion or equine rhinopneumonitis

  17. Streptococcus suis bacterin and subunit vaccine immunogenicities and protective efficacies against serotypes 2 and 9. (United States)

    Baums, Christoph Georg; Kock, Christoph; Beineke, Andreas; Bennecke, Katharina; Goethe, Ralph; Schröder, Charlotte; Waldmann, Karl-Heinz; Valentin-Weigand, Peter


    Streptococcus suis causes numerous diseases in pigs, most importantly, meningitis, arthritis, septicemia, and bronchopneumonia. One of the major problems in modern swine production is the lack of a vaccine protecting against more than one S. suis serotype. The objective of this study was to determine the protective efficacy of a serotype 2 murein-associated protein (MAP) fraction subunit vaccine in comparison to that of a bacterin against experimental challenge with serotype 2 (containing muramidase-released protein [MRP], extracellular factor, and suilysin [SLY]) and serotype 9 (containing MRP variant MRP* and SLY) strains. MAP was shown to include different surface-associated proteins, such as the MRP and surface antigen one (SAO) expressed by both pathotypes used for challenge. The results of this study demonstrated that the serotype 2 bacterin induced protective immunity against homologous challenge. In contrast, the protective efficacy of the MAP subunit vaccine was low, though MAP immunization resulted in high serum immunoglobulin G2 titers against MRP and SAO. Importantly, immunization with bacterin but not with MAP induced opsonizing antibody titers against the serotype 2 strain, and these antibody titers were found to correlate with protection. However, after absorption with a nonencapsulated isogenic mutant, the sera from bacterin-immunized piglets failed to facilitate neutrophil killing, indicating that antibodies directed against capsule may not have been essential for opsonophagocytosis. Furthermore, induction of opsonizing antibodies against serotype 9 was not detectable in the group receiving bacterin or in the group receiving the MAP vaccine. In agreement, protection against the heterologous serotype 9 strain was low in both groups. Thus, identification of an antigen protecting against these two important S. suis pathotypes remains an important goal of future studies.

  18. Role of glucose and CcpA in capsule expression and virulence of Streptococcus suis. (United States)

    Willenborg, J; Fulde, M; de Greeff, A; Rohde, M; Smith, H E; Valentin-Weigand, P; Goethe, R


    Streptococcus suis is one of the most important pathogens in pigs and is also an emerging zoonotic agent. After crossing the epithelial barrier, S. suis causes bacteraemia, resulting in meningitis, endocarditis and bronchopneumonia. Since the host environment seems to be an important regulatory component for virulence, we related expression of virulence determinants of S. suis to glucose availability during growth and to the sugar metabolism regulator catabolite control protein A (CcpA). We found that expression of the virulence-associated genes arcB, representing arcABC operon expression, cps2A, representing capsular locus expression, as well as sly, ofs, sao and epf, differed significantly between exponential and early stationary growth of a highly virulent serotype 2 strain. Deletion of ccpA altered the expression of the surface-associated virulence factors arcB, sao and eno, as well as the two currently proven virulence factors in pigs, ofs and cps2A, in early exponential growth. Global expression analysis using a cDNA expression array revealed 259 differentially expressed genes in early exponential growth, of which 141 were more highly expressed in the CcpA mutant strain 10ΔccpA and 118 were expressed to a lower extent. Interestingly, among the latter genes, 18 could be related to capsule and cell wall synthesis. Correspondingly, electron microscopy characterization of strain 10ΔccpA revealed a markedly reduced thickness of the capsule. This phenotype correlated with enhanced binding to porcine plasma proteins and a reduced resistance to killing by porcine neutrophils. Taken together, our data demonstrate that CcpA has a significant effect on the capsule synthesis and virulence properties of S. suis.

  19. Streptococcus suis Bacterin and Subunit Vaccine Immunogenicities and Protective Efficacies against Serotypes 2 and 9▿† (United States)

    Baums, Christoph Georg; Kock, Christoph; Beineke, Andreas; Bennecke, Katharina; Goethe, Ralph; Schröder, Charlotte; Waldmann, Karl-Heinz; Valentin-Weigand, Peter


    Streptococcus suis causes numerous diseases in pigs, most importantly, meningitis, arthritis, septicemia, and bronchopneumonia. One of the major problems in modern swine production is the lack of a vaccine protecting against more than one S. suis serotype. The objective of this study was to determine the protective efficacy of a serotype 2 murein-associated protein (MAP) fraction subunit vaccine in comparison to that of a bacterin against experimental challenge with serotype 2 (containing muramidase-released protein [MRP], extracellular factor, and suilysin [SLY]) and serotype 9 (containing MRP variant MRP* and SLY) strains. MAP was shown to include different surface-associated proteins, such as the MRP and surface antigen one (SAO) expressed by both pathotypes used for challenge. The results of this study demonstrated that the serotype 2 bacterin induced protective immunity against homologous challenge. In contrast, the protective efficacy of the MAP subunit vaccine was low, though MAP immunization resulted in high serum immunoglobulin G2 titers against MRP and SAO. Importantly, immunization with bacterin but not with MAP induced opsonizing antibody titers against the serotype 2 strain, and these antibody titers were found to correlate with protection. However, after absorption with a nonencapsulated isogenic mutant, the sera from bacterin-immunized piglets failed to facilitate neutrophil killing, indicating that antibodies directed against capsule may not have been essential for opsonophagocytosis. Furthermore, induction of opsonizing antibodies against serotype 9 was not detectable in the group receiving bacterin or in the group receiving the MAP vaccine. In agreement, protection against the heterologous serotype 9 strain was low in both groups. Thus, identification of an antigen protecting against these two important S. suis pathotypes remains an important goal of future studies. PMID:19109449

  20. Avaliação nutricional de lactentes hospitalizados Nutritional evaluation of hospitalized suckling childrem

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    João Guilherme Bezerra Alves


    Full Text Available Investigou-se a evolução ponderal, conforme o valor das quotas calóricas de dietas prescritas (QCP e aceitas (QCA de lactentes internados por diarréia ou broncopnemonia no Instituto Materno Infantil de Pernambuco, Brasil. A proporção de crianças que ganharam ou não ganharam peso foi avaliada em função das QCP E QCA que atingiram as quotas calóricas ideais (QCI durante o internamento, verificando-se que 46% das crianças perderam ou mantiveram o peso nos dois primeiros dias. Houve maior freqüência de ganho de peso associado às QCP e QCA que atingiram as QCI, bem como entre as crianças amamentadas. Concluiu-se existir deficiente evolução ponderal relacionada às baixas quotas calóricas oferecidas ou aceitas durante a hospitalização.This work investigated the body weight evolution according to prescribed or accepted dietetic caloric value, in children with diarrhea or bronchopneumonia, admitted at Instituto Materno Infantil de Pernambuco, Brazil. The proportions of children who increased or did not increase body weight were evaluated as a function of the prescribed caloric quota (PCQ and the accepted caloric quota (ACQ that attained the ideal caloric quota (ICQ during hospitalization. 46% children lost or maintained the weight during the two first days. A higher frequency of increased weight was observed when PCQ or ACQ attained the ICQ, as well as in breast feeding children. Therefore, this study confirmed the relationship between low caloric values offered or accepted with a deficient body weight evolution.

  1. Influence of acute renal failure on the mononuclear phagocytic system

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    V.R.A. Sousa


    Full Text Available Several studies show the ability of macrophages to remove particles injected into the bloodstream. This function seems to be increased in the presence of acute renal failure. The objective of the present study was to assess the phagocytic function of the main organs (spleen, liver and lung of the mononuclear phagocytic system in renal and postrenal failures. Fifteen rats (250-350 g were divided into three groups (N = 5: group I - control; group II - ligature of both ureters, and group III - bilateral nephrectomy. On the third postoperative day, all animals received an iv injection of 1 ml/kg 99mTc sulfur colloid. Blood samples were collected for the assessment of plasma urea, creatinine, sodium, and potassium concentrations and arterial gasometry. Samples of liver, spleen, lung and blood clots were obtained and radioactivity was measured. Samples of liver, spleen, lung and kidney were prepared for routine histopathological analysis. Plasma urea, creatinine and potassium concentrations in groups II and III were higher than in group I (P<0.05. Plasma sodium concentrations in groups II and III were lower than in group I (P<0.05. Compensated metabolic acidosis was observed in the presence of postrenal failure. Group II animals showed a lower level of radioactivity in the spleen (0.98 and lung (2.63, and a higher level in the liver (105.51 than control. Group III animals showed a lower level of radioactivity in the spleen (11.94 and a higher level in the liver (61.80, lung (11.30 and blood clot (5.13 than control. In groups II and III liver steatosis and bronchopneumonia were observed. Renal and postrenal failures seem to interfere with blood clearance by the mononuclear phagocytic system.

  2. [Diabetic ketoacidosis. Revision of 82 episodes]. (United States)

    Zanchetta, J R; Cortés, E; Pallotta, M G; Domínguez, J M


    A total of 82 episodes of diabetic ketoacidosis were analysed in 70 adult patients. Population characteristics can be seen in Table 1. It was possible to determine the causes of 74 episodes (Table 2); infections, insulin reduction or suppression and psychic stress included 89 % of these causes. The most frequent infection sites were airway, urinary tract and skin surface. The most important symptoms and signs shown by patients on admission (Table 3) were digestive and those derived from dehydration and acidosis. Figure 2 shows laboratory data on admission: average glycemia, 395 mg %, 90 % with pH values below 7.30; the majority revealed high hematocrit urea and kaliemia values. Unusual treatment performed in the classical way (Figure 3) can be divided into two periods: the first of eapid expansion and insulinization (first three hours) and the second of slow replenishment (4 to 24 hours) consisting of two stages in which the velocity of liquid infusion is diminished while glucose and potassium backing is started. No difference was found between the results of those who received bicarbonate and those who did not (Table 4). Response to treatment is shown in Fig. 4. On pointing out the decrease in kalemia (1.18 mEq/l in the first 6 hours), however, it must be kept in mind that on admission 10 % of the patients were in a state of hypokalemia with less than 3.5 mEq/l. Table 5 shows complications that arose during treatment: hypokalemia, 32 %; hupoglucemia, 11 % and phlebitis, 17 % (catheterized). Five patients, (7 5) died. Four had been admitted in a state of coma with a severe infectious state (bronchopneumonia, acute pyelonephritis, meningo-encephalitis). The analysis of this paper shows the importance of an adequate diabetic education and briefing both for the patients, to be aware of the unleashing factors, and for the physicians, in order to avoid the complications of treatment.

  3. Isolation, characterization, antibiogram and pathology of Pasteurella multocida isolated from pigs

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    Mamta Tigga


    Full Text Available Aim: Isolation, characterization and antibiogram of Pasteurella multocida from diseased pigs of district Durg of Chhattisgarh, and to study pathological changes caused by swine pasteurellosis. Materials and Methods: An outbreak of swine pasteurellosis was suspected in pigs of Ruwabandha (Bhilai, Anjora, Somni, Tedesara, Tirgajhola villages of Durg district in Chhattisgarh, India during August and September of 2011. Nasal Swabs and blood samples from ailing pigs and heart blood and impression smears from morbid pigs were processed for detection and isolation of P. multocida by bacteriological methods. Detailed necropsy was conducted and gross and histopathological lesions were recorded. The test Isolates were subjected to antimicrobial sensitivity profile by disc-diffusion method. Results: The blood smears from heart blood and tissue impression smears revealed teaming of bipolar organisms indicating the presence of Pasteurella spp. The isolates obtained were subjected to Gram's staining for checking the purity and bipolar morphology and characterized biochemically. Gross lesions included severe acute pneumonia and haemorrhages in lungs, petechial haemorrhages on serous membranes and other visceral organs. On histopathological examination, lungs showed typical fibrinous bronchopneumonia, multifocal suppuration. All the isolates of P. multocida were 100% sensitive to Amoxicillin, Gentamicin, Enrofloxacin and showed100% resistance to Ceftizoxim and Cloxacillin. Conclusion: Gross and microscopic lesions in dead animals are of great diagnostic value and are of characteristic of P. multocida infection. Cultural, morphological and biochemical characters are useful to rule out the causative agent as P. multocida. Antibiotic sensitivity pattern of the isolates should routinely be carried out for knowing the antibiotic resistance trends in an endemic area.


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    Shaikh Mohammed Aslam


    Full Text Available BACKGROUND Severe sepsis and septic shock are increasing in incidence and contributing significantly to mortality. The prediction of outcome for elderly patients with sepsis may facilitate more aggressive interventions. The SOFA score is a scoring system used to quantify the severity of the patient’s illness based on the degree of organ dysfunction. Various biomarkers are being evaluated for early diagnosis of sepsis. RDW is one of them, which have been shown to predict mortality and morbidity of sepsis. Hence, this study is being done to compare RDW with SOFA score as prognostic marker of sepsis in elderly patients. AIM To compare red cell distribution width with SOFA score as a prognostic marker of sepsis in elderly patients. METHODS A total of 93 elderly patients in sepsis who were admitted to Intensive Care Unit of M. S. Ramaiah Hospitals between October 2013 and September 2015 were included in the study. ROC (Receiver Operating Curve was used to determine the optimal cut-off point for RDW for predicting mortality. ROC of RDW was compared with ROC of SOFA score. RESULTS Mean age of the patients was 70.72±8.02 and most of the patients were in the age group of 61–70yrs. (53.8%. 52(55.9% patients were males and 41(44.1% patients were females. Bronchopneumonia (34.4% and urosepsis (30.1% were the most common causes of sepsis; 61.3% of the patients had SOFA score in the range of 5–10. Mean SOFA score was 7.87097±3.22769. Mean RDW was 14.247±2.1151. CONCLUSION RDW had a sensitivity of 81.6%, specificity of 77.3%, positive predictive value of 80%, and negative predictive value of 79.1% with a cut-off value of 13.75% in predicting mortality in elderly patients in sepsis.

  5. Adherence to clinical practice guidelines on community acquired pneumonia and its relation to mortality rates.

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    María Caridad Fragoso Marchante


    Full Text Available Background: Community acquired pneumonia is a common disease that is associated with significant morbidity and mortality rates. In the General University Hospital ´´Dr. Gustavo Aldereguía Lima¨ in Cienfuegos, there are guidelines for the management of patients with community-acquired pneumonia, but no studies have been conducted as to the relation between their compliance and the mortality rate. Objective: To assess the adherence to guidelines for diagnosis and treatment of community-acquired pneumonia and its relation to mortality in hospitalized patients. Methods: A descriptive, observational and prospective case series study was conducted in all patients with a diagnosis of pneumonia or bronchopneumonia at the moment of admission and discharge from June 2006 to May 31, 2007. The relation between the different variables and the mortality rate was analyzed as to the different types of risks and the overall compliance with the guidelines for each risk with mortality. A multivariate analysis (logistic regression was performed, with a 95% confidence interval. Results: The results are presented in tables of numbers and percent. Variables independently associated with mortality were: age (over 65 years old people, radiological lesions in more than one lobe or bilateral, atypical pneumonia debut, negative assessments as to the adherence to guidelines and inadequate treatments. Conclusion: The variables included in the study were enough to explain the final outcome of the patients, so it could be determined, for the first time in Cienfuegos, that the non-compliance with the guidelines of good clinical practice is related to mortality rates.

  6. Swine flu outbreak 2015-Paediatric Experience in a Tertiary Care Centre.

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    Dr. Anuya Chauhan


    Full Text Available Background & Aim: To study and analyse the clinical profile and outcome of children admitted with Influenza A positive cases at our Tertiary Care Centre in 2015. Materials & Methods: Prospective study conducted in a tertiary care centre (Civil Hospital B. J. Medical College, Ahmedabad from Jan 2015 to March 2015. 340 Children presenting with clinical features compatible with category C were admitted and 199 patients having laboratory confirmed influenza A (H1N1 were included in our study. Details regarding clinical features, examination findings, investigations, complications and treatment were recorded and analysed in a systemic manner. Results: Study showed that highest incidence of influenza A was seen in 1-3 years age group (41.7% Male-female ratio was 1.18:1 indicating similar affection of both sexes. Maximum patients presented within first 3 days of illness (53.2% with fever (82.9% followed by dry cough (74.6% and sore throat (52.7% as presenting symptoms. Leucopenia (79.4% was the most common laboratory finding and lobar pneumonia (81.1% was the most common radiological finding followed by bronchopneumonia (18.9%. Conjunctivitis (20.1% and otitis media (6.03% were the common complications. Mortality rate in our set up was 6.5% (13 out of 199; with maximum from 1-3 year age group (46.1%, most common cause being ARDS (46.1%. Conclusion: The outbreak of influenza A (H1N1 2015 predominantly affected young population with significant morbidity and mortality. With the efforts of healthcare authorities worldwide, we have still not lost the race against fighting this virus.

  7. Total replacement of the exocrine pancreas with fat following multiple blunt injuries. (United States)

    Hayashi, Takahito; Yoshida, Aichi; Ago, Kazutoshi; Ago, Mihoko; Ogata, Mamoru


    We describe an unusual case of total replacement of the exocrine pancreas with fat, which was observed in an autopsy of an assaulted victim. A woman in her early 80s was kicked, stamped and hit several times with firewood. She was hospitalized with disturbance of consciousness, left haemothorax and multiple fractures, and died about three months later. Postmortem examination revealed extensive abrasions and bruises, multiple fractures and internal organ injuries such as contusion and haemorrhage, as well as bronchopneumonia. It was concluded that the cause of her death was hypostatic pneumonia followed by traumatic shock due to multiple blunt injuries. Further, complete replacement of the pancreas with fat was observed in addition to a calculus in the main pancreatic duct and fibrous hypertrophy of the ductal wall. Histopathological examination revealed almost complete replacement of the pancreatic acini by fat tissue, whereas the islets of Langerhans were mostly intact. Antemortem laboratory data showed that serum amylase levels were almost within normal range before hospital admission, but underwent a transient abnormal elevation at admission followed by extremely low levels thereafter. Previous reports suggest that obstruction of both the main pancreatic duct and the artery, due to tumour formation or calculus in combination with arteriolar sclerosis, are necessary to induce total replacement of the pancreas with fat. Since arteriolar sclerosis was not remarkable in this case, we speculated that pancreatic ischaemia due to circulatory disturbance caused by traumatic shock, in combination with pre-existing calculus, may have contributed to the development of total replacement with fat. The temporal alterations in serum amylase levels support our speculation. There are few, if any, reports regarding organ replacement with fat in association with trauma. This case suggests that multiple injuries followed by traumatic shock may advance pre-existing replacement of

  8. Optimizing the use of cadavers by integrating pathology during anatomy dissection. (United States)

    Geldenhuys, Elsje-Márie; Burger, Elsie Helena; van Helden, Paul David; Mole, Calvin Gerald; Kotzé, Sanet Henriët


    An accurate knowledge of anatomy, especially natural variation within individuals, is of vital clinical importance. Cadaver dissection during anatomical training may be a valuable introduction to pathology for undergraduate students, which can contribute greatly to a successful medical career. The purpose of this study was to determine the extent and type of pathology lesions in a cadaver population (n = 127) used for medical dissection. This was done to gauge whether sufficient pathology lesions representative of all the organ systems were present in the cadaver population to warrant the use of cadavers as an additional pathology learning resource. This study demonstrated a wide variety of pathology lesions in different organ systems. The respiratory system was most affected with pulmonary tuberculosis (TB) lesions being the most common finding (seen in 76% of cadavers) followed by bronchopneumonia and emphysema. Other common pathology findings included atherosclerosis, colonic diverticula, and chronic pyelonephritis. Skeletal fractures and degenerative joint disease were also noted. This study shows that cadaveric dissection offers a chance to alert and expose students to a wide variety of gross pathology and histopathology. It has been suggested that most medical students will practice in primary health care and as such more attention should be given to the pathology of commonly encountered diseases. This is particularly true for developing countries, where diseases such as TB are commonly encountered. The integration of pathology into the dissection hall may therefore be beneficial to student learning while simultaneously optimizing the use of cadaver material. Anat Sci Educ 9: 575-582. © 2016 American Association of Anatomists.

  9. The expression of membrane interleukin-2 receptor(CD25) on the surface of peripheral blood mononuclear cells(PBMC) of pulmonary tuberculosis and its clinical significance%肺结核患者PBMC膜白介素-2受体(CD25)表达及其临床意义

    Institute of Scientific and Technical Information of China (English)

    王健; 李朝品; 刘智; 刘炳祥


    目的:探讨外周血单个核细胞(PBMC)膜白介素-2受体(CD25)表达在肺结核病鉴别诊断中的应用价值.方法:用生物素-链霉亲和素(BSA)法检测肺结核、支气管肺炎患者T细胞亚群及植物血凝素(PHA)诱导前后CD25表达水平.结果:支气管肺炎患者CD3+、CD4+、CD8+水平分别为(62.32±6.34)%、(47.52±7.16)%、(32.12±6.55)%,CD4+/CD8+ 比值为1.52±0.43,PHA诱导前后CD25水平分别为(4.56±1.52)%、(35.12±7.21)%.空洞型肺结核CD3+、CD4+、CD8+、CD4+/CD8+水平分别为(41.13±5.25)%、(43.38±5.15)%、(36.25±3.46)%和1.15±0.21,非空洞型肺结核CD3+、CD4+、CD8+、CD4+/CD8+水平分别为(46.29±5.60)%、(47.21±4.86)%、(32.36±4.03)%、1.46±0.25,相互比较CD3+、CD4+/CD8+差异均有显著性(P<0.01和P<0.05).空洞型肺结核与非空洞型肺结核患者PHA诱导前后CD25水平分别为(2.13±1.14)%、(27.25±3.50)%和(3.43±1.35)%、(31.14±4.11)%,两者相比差异均有显著性(P<0.01).结论:肺结核病患者体内存在明显的细胞免疫功能紊乱,主要表现为CD25表达水平降低,CD25表达水平与肺结核病的病情似有一定关系,其对肺结核病鉴别诊断具有重要价值.%Objective:To study the value of membrane interleukin-2 receptor(CD25) of peripheral blood mononuclear cells (PBMC) on the differential diagnosis of pulmonary tuberculosis. Methods:The expression of T cell subset and levels of CD25 before and after induction with PHA were detected by biotin-streptavidin(BSA) in patients with pulmonary tuberculosis and bronchopneumonia. Results:The levels of CD3+, CD4+, CD8+, CD4+/CD8+ and CD25 before and after induction in peripheral blood in patients with bronchopneumonia were(62.32±6.34)%,(47.52±7.16)%,(32.12±6.55)%, 1.52±0.43,(4.56±1.52)%,and (35.12±7.21)%,respectively. The levels in pulmonary tuberculosis with cavity were(41.13±5.25)%,(43.38±5.15)%,(36.25±3.46)%, 1.15±0.21,(2.13±1.14)%,and (27.25±3.50)% and in pulmonary tuberculosis

  10. Autopsy-proven causes of death in lungs of patients immunocompromised by secondary interstitial pneumonia Causas de óbito por pneumonia intersticial secundária em autópsias pulmonares de pacientes imunocomprometidos

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    Alberto Antonio Terrabuio Junior


    Full Text Available PURPOSE: To present the more frequent associations found in autopsies of immunocompromised patients who developed secondary interstitial pneumonia as well as the risk of death (odds ratio in having specific secondary interstitial pneumonia according to the cause of immunocompromise. METHOD: From January 1994 to March 2004, 17,000 autopsies were performed at Hospital das Clínicas, São Paulo University Medical School. After examining the pathology report review, we selected 558 of these autopsies (3.28% from patients aged 15 years or more with primary underlying diseases who developed radiologically diffuse infiltrates of the lung during their hospital course and died after secondary interstitial pneumonia (bronchopneumonia, lobar pneumonia, interstitial pneumonia, diffuse alveolar damage, pulmonary recurrence of underlying disease, drug-induced lung disease, cardiogenic pulmonary edema, or pulmonary embolism. Histology slides were reviewed by experienced pathologists to confirm or not the presence of secondary interstitial pneumonia. Statistical analysis included the Fisher exact test to verify any association between histopathology and the cause of immunocompromise; a logistic regression was used to predict the risk of death for specific histological findings for each of the independent variables in the model. RESULTS: Secondary interstitial pneumonia was histologically represented by diffuse interstitial pneumonitis ranging from mild nonspecific findings (n = 213 to a pattern of diffuse alveolar damage (n = 273. The principal causes of immunocompromise in patients with diffuse alveolar damage were sepsis (136 cases, neoplasia (113 cases, diabetes mellitus (37 cases, and transplantation (48 cases. A high risk of death by pulmonary edema was found for patients with carcinoma of colon. Similarly, in patients with lung cancer or cachexia, A high risk of death by bronchopneumonia (OR = 3.6; OR = 2.6, respectively was found. Pulmonary

  11. Clinical Characteristics and CT Findings of Pulmonary Mycosis in Children%儿童真菌性肺炎的临床特点及HRCT诊断

    Institute of Scientific and Technical Information of China (English)

    周俊霖; 苗静; 丁山; 吕静; 程力


    目的 探讨儿童真菌性肺炎的临床特点及高分辨率CT(HRCT)表现,以利早期诊断治疗,改善预后.资料与方法回顾性分析2005年至2010年住院确诊为真菌性肺炎的20例患儿资料.结果 20例均伴有基础疾病,并且都有发热.原发病为支气管肺炎者5例,继发于其他疾病者15例(白血病12例.再生障碍性贫血、神经母细胞瘤及重症联合免疫缺陷病各1例).20例均行HRCT检查,肺亚段及肺小叶实变10例,结节或肿块样改变4例,空洞3例,霉菌球3例,"新月征"2例,粟粒样改变1例.结论 儿童真菌性肺炎不易诊断,但恶性血液系统疾病和严重免疫抑制是儿童真菌性肺炎发病的重要因素.应结合临床病史、影像学及实验室检查全面分析,及时诊断.%Objective To investigate clinical characteristics and CT findings of Pulmonary mycosis in children. Materials and Methods Clinical data of twenty children with Pulmonary mycosis between 2005 and 2010 were retrospectively studied. Results All the patients had underlying diseases including bronchopneumonia( n = 5 ) ,leukemia ( n = 12 ) , aplastic anemia( n = 1 ), neuroblastoma( n = 1 ) and severe combined immunodeficiency ( n = 1 ). CT scans were performed in20 eases. HRCT features included segmental or lobar consolidation in 10 cases,nodule or mass-like lesions in 4 eases,cavities with thick/thin wall in 3 cases,fungal balls in 5 cases, "halo" signs in 2 and miliary distribution in 1 case. Conclusion Pulmonary mycosis in children are difficult to diagnose. Hematological malignancy and significant immunosuppression tend to play important roles in Pulmonary mycosis. Clinical history, HRCT features and laboratory results are sufficiently informative for accurate diagnosis.

  12. Clinical Effect of Tanreqing Injection in the Treatment of Children with Acute Lower Respiratory Tract Infection%痰热清辅助治疗小儿急性下呼吸道感染疗效观察

    Institute of Scientific and Technical Information of China (English)

    肖铮铮; 宋涛; 王玮


    目的 观察痰热清注射液辅助治疗小儿急性下呼吸道感染的疗效和安全性.方法 将50例患儿随机分为两组,治疗组25例,在常规治疗基础上给予痰热清注射液0.3~0.5 mg/(kg·d),每天1次,静脉滴注;对照组25例,给予常规治疗,观察两组治疗后发热、咳嗽、喘息及肺部阳性体征消失时间.结果 观察组的有效率为92%,对照组的有效率为80%,两组有效率差异无统计学意义(P>0.05).而退热、止咳、止喘、体征消失时间两组差异均有统计学意义(P<0.05).结论 痰热清辅助治疗小儿急性下呼吸道感染疗效好,安全性高,值得临床推广.%Objective To investigate the clinical effect of tanreqing injection and its safety in treatment on child with acute lower respiratory tract infection. Methods Fifty cases of child bronchopneumonia were divided into two groups: on the basis of routine method,the observed group(25 cases) was treated with tanreqing injection 0.3-0.5 mg/(kg · d) ,1 time a day,the control group(25 cases) was treated with routine drugs. The two groups were observed in the disappearance time of fever, cough, wheezing and positive signs of the lungs after treatment. Results The valid rate of observed group was 92% and the control group 80% ,there were not significantly different(P >0.05) ,the significant differences on the aspects of pyretolysis,cough stopping, wheezing stopping,physical sign disappearing were found between the observed group and the control group(P <0. 05). Conclusion Tanreqing injection was effective in the treatment of children with acute lower respiratory tract infection and heart failure,and it was worth clinical use.

  13. The Spl Serine Proteases Modulate Staphylococcus aureus Protein Production and Virulence in a Rabbit Model of Pneumonia (United States)

    Salgado-Pabon, Wilmara; Meyerholz, David K.; White, Mark J.; Schlievert, Patrick M.


    ABSTRACT The Spl proteases are a group of six serine proteases that are encoded on the νSaβ pathogenicity island and are unique to Staphylococcus aureus. Despite their interesting biochemistry, their biological substrates and functions in virulence have been difficult to elucidate. We found that an spl operon mutant of the community-associated methicillin-resistant S. aureus USA300 strain LAC induced localized lung damage in a rabbit model of pneumonia, characterized by bronchopneumonia observed histologically. Disease in the mutant-infected rabbits was restricted in distribution compared to that in wild-type USA300-infected rabbits. We also found that SplA is able to cleave the mucin 16 glycoprotein from the surface of the CalU-3 lung cell line, suggesting a possible mechanism for wild-type USA300 spreading pneumonia to both lungs. Investigation of the secreted and surface proteomes of wild-type USA300 and the spl mutant revealed multiple alterations in metabolic proteins and virulence factors. This study demonstrates that the Spls modulate S. aureus physiology and virulence, identifies a human target of SplA, and suggests potential S. aureus targets of the Spl proteases. IMPORTANCE Staphylococcus aureus is a versatile human pathogen that produces an array of virulence factors, including several proteases. Of these, six proteases called the Spls are the least characterized. Previous evidence suggests that the Spls are expressed during human infection; however, their function is unknown. Our study shows that the Spls are required for S. aureus to cause disseminated lung damage during pneumonia. Further, we present the first example of a human protein cut by an Spl protease. Although the Spls were predicted not to cut staphylococcal proteins, we also show that an spl mutant has altered abundance of both secreted and surface-associated proteins. This work provides novel insight into the function of Spls during infection and their potential ability to degrade

  14. Quadro epdiemiológico das mortes súbitas na infância em cidades gaúchas (Brasil Epidemiology of sudden infant deaths in cities of Rio Grande do Sul, Brazil. A comparative study of cases and controls

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    Cesar Gomes Victora


    , maternal smoking, and mixed or artificial feeding. None of the 72 deaths had been certified as such by the physicians who filled in the death certificates, the majority of which referred to "bronchopneumonia" as the undereying cause.

  15. Avaliação da qualidade da informação sobre a causa básica de óbitos infantis no Rio Grande do Sul (Brasil Assessment of the quality of information on basic causes of infant death in Rio Grande do Sul (Brazil

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    Letícia C. Nobre


    Full Text Available A partir de dados coletados para um estudo de casos e controles sobre mortalidade infantil por doenças infecciosas e desnutrição realizado em Porto Alegre e Pelotas, RS (Brasil, comparou-se as causas de óbito constantes do atestado médico com as causas obtidas através de uma revisão detalhada, realizada pela equipe da investigação. Concluiu-se que as estatísticas oficiais não são fidedignas, tendo havido sobre-registro de broncopneumonias (CID 485X e de septicemias (CID 038.9, e sub-registro de gastroenterites (CID 009.1 e de mortes súbitas (CID 798.0. A concordância entre os atestados refeitos e os oficiais, em termos de grupos de causas de óbito, foi de apenas 27.9%.The validity of the official information on the causes of infant deaths was studied in the Brazilian cities of Porto Alegre and Pelotas in 1985. Using data collected for a population-based case-control study of infant mortality due to infectious diseases or malnutrition, a comparison was made between the causes of death reported on the death certificates and those obtained after a careful review of case-notes and a medical interview with the parents of the deceased infants. Official death certificates showed an excess of deaths attribute to bronchopneumonia (ICD 485X and septicemia (ICD 038.9, and an underestimation of the number of deaths due to diarrheal diseases (ICD 009.1 and of sudden infant deaths (ICD 798.0. The overall rate of agreement between official and revised certificates, in terms of groups of causes of death, was only 27.9%. Lower respiratory infections, which were the leading infectious cause of infant deaths according to official statistics, were superseded by diarrheal diseases after this revision.

  16. T-2 toxin impairs murine immune response to respiratory reovirus and exacerbates viral bronchiolitis. (United States)

    Li, Maoxiang; Harkema, Jack R; Islam, Zahidul; Cuff, Chistopher F; Pestka, James J


    Exposure to immunosuppressive environmental contaminants is a possible contributing factor to increased occurrence of viral respiratory diseases. The objective of this study was to test the hypothesis that the trichothecene mycotoxin T-2 toxin (T-2), a frequent food contaminant, alters host resistance to lung infection by reovirus, a model respiratory virus. Balb/c mice (4 week old) were treated intraperitoneally with T-2 toxin (1.75 mg/kg bw) or saline vehicle and then intranasally instilled 2 h later with 10(7) plaque forming unit (PFU) of reovirus, strain Lang (T1/L) or saline vehicle. At 10 days post-instillation (PI), both virus plaque-forming responses and reovirus L2 gene expression were 10-fold higher in lungs of T-2-treated mice compared to controls. No-effect and lowest-effect levels for T-2-induced suppression of reovirus clearance were 20 and 200 microg/kg bw, respectively. Respiratory reovirus infection resulted in a mild bronchiolitis with minimal alveolitis, which was markedly exacerbated by T-2 pretreatment. Reovirus exposure induced marked increases in total cells, neutrophils and lymphocytes at 3 and 7 days PI in bronchial alveolar lavage fluid (BALF) whereas macrophages were increased only at 7 days PI. Although prior T-2 exposure attenuated total cell and macrophage counts in BALF of control and infected mice at 3 days PI, the toxin potentiated total cell, macrophage, neutrophil and lymphocyte counts in infected mice at 7 days PI. At 3 days PI, T-2 suppressed reovirus-induced IFN-gamma elevation in BALF, but enhanced production of IL-6 and MCP-1. T-2 pretreatment also suppressed reovirus-specific mucosal IgA responses in lung and enteric tract, but potentiated serum IgA and IgG responses. Taken together, T-2 increased lung viral burden, bronchopneumonia and pulmonary cellular infiltration in reovirus-infected mice. These effects might be attributable to reduced alveolar macrophage levels as well as modulated cytokine and mucosal Ig responses.

  17. Clinical efficacy of meloxicam (Metacam) and flunixin (Finadyne) as adjuncts to antibacterial treatment of respiratory disease in fattening cattle. (United States)

    Friton, Gabriele M; Cajal, Carlos; Ramirez Romero, Rafael; Kleemann, Rainer


    The clinical efficacy of two non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam (Metacam 20 mg/ml) and flunixin meglumine (Finadyne), as adjuncts to antibacterial therapy in the treatment of acute febrile respiratory disease in cattle was compared. The randomised blind, positive controlled study was conducted under feedlot conditions in Mexico. Overall, 201 female cattle (weighing 220-250 kg) diagnosed with bronchopneumonia at the feedlot were recruited into the study. On Day 0 all animals were treated with 20 mg oxytetracycline/kg body-weight (Bivatop 200) by subcutaneous injection, in conjunction with either meloxicam (0.5 mg/kg subcutaneously, Metacam 20 mg/ml, n = 100), or flunixin meglumine (2.2 mg/kg intravenously, Finadyne, n = 101). According to label instructions, meloxicam was administered as a single dose, whereas flunixin meglumine could be administered daily for up to 3 consecutive days depending on the rectal temperature (with re-administration, if rectal temperature > or = 40.0 degrees C). Rectal temperature, respiratory rate, appetite, dyspnoea, coughing, nasal discharge and general condition were recorded on Days 0 (prior to treatment), 1, 2, 3 and 7 using a weighted numerical score. Scores were summed to generate a 'Clinical Sum Score' (CSS, range 7 to 24 points). Individual animal body weights were measured on Days 0 and 7. Nasal swabs were collected from 10 animals per treatment group on Day 0 for microbiological culture. Clinical parameters and the mean CSS showed no significant differences between treatment groups with mean CSS on Days 0 and 7 of 16.18 and 10.55 in the meloxicam group and 16.41 and 10.88 in the flunixin meglumine group. However, a significantly lower mean rectal temperature was measured in the meloxicam group on Day 2 (p flunixin meglumine was performed in 45% of the animals. No suspected adverse drug events related to treatments were reported. It is concluded that a single subcutaneous dose of meloxicam was as

  18. Amiloidose renal em cão Shar-Pei: Relato de Caso Renal amyloidosis in a Shar-Pei dog: A case report

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    J.L. Reis Jr.


    Full Text Available O presente relato descreve os achados clínicos e anatomopatológicos de um caso de amiloidose renal em um cão macho de nove anos da raça Shar-Pei. O animal apresentava quadro clínico de esporotricose e de insuficiência renal e exames positivos para erlichiose e leishmaniose. No dia anterior ao óbito, o cão apresentou apatia, desidratação e anúria. À necropsia foram observados inúmeros pontos milimétricos esbranquiçados localizados no córtex renal e hepatização do lobo diafragmático esquerdo. O achado histológico mais importante foi deposição de material eosinofílico, amorfo e acelular localizado nos tufos glomerulares que se corou positivamente pelo vermelho congo (amilóide. Observaram-se nefrite supurada multifocal, espessamento da cápsula de Bowman e broncopneumonia supurada crônica, com fibrose intensa. A origem da amiloidose, no presente caso, poderia ser hereditária, assemelhando-se à amiloidose familiar descrita em cães da raça Shar-Pei, ou ser devida à inflamação supurada crônica e/ou leishmaniose.The clinical and pathological findings of a case of renal amyloidosis in a nine-year-old male Shar-Pei dog were described. Clinically, there were signs of sporotrichosis and renal insufficiency, besides being positive to leishmaniasis and ehrlichiosis. On the day before death, the animal became apathetic, dehydrated and anuric. On gross examination, there were several whitish millimetric spots seen widespread in both renal cortices and consolidation of the left diaphragmatic pulmonary lobe. The most important microscopic finding was a deposition of amorphous acellular material on the glomerular tufts which stained positively by congo red stain. Other changes were multifocal suppurative nephritis, thickening of the Bowman capsule and chronic suppurative bronchopneumonia. The origin of the amyloidosis in this case could be hereditary, being similar to familiar amyloidosis described in Shar-Pei breed, or due to

  19. Histopathological and immunohistochemical findings of swine with spontaneous influenza A infection in Brazil, 2009-2010

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    Tatiane T.N. Watanabe


    Full Text Available Swine influenza (SI is caused by the type A swine influenza virus (SIV. It is a highly contagious disease with a rapid course and recovery. The major clinical signs and symptoms are cough, fever, anorexia and poor performance. The disease has been associated with other co-infections in many countries, but not in Brazil, where, however, the first outbreak has been reported in 2011. The main aim of this study was to characterize the histological features in association with the immunohistochemical (IHC results for influenza A (IA, porcine circovirus type 2 (PCV2 and porcine reproductive and respiratory syndrome virus (PRRSV in lung samples from 60 pigs submitted to Setor de Patologia Veterinária at the Universidade Federal do Rio Grande do Sul (SPV-UFRGS, Brazil, during 2009-2010. All of these lung samples had changes characterized by interstitial pneumonia with necrotizing bronchiolitis, never observed previously in the evaluation of swine lungs in our laboratory routine. Pigs in this study had showed clinical signs of a respiratory infection. Swine samples originated from Rio Grande do Sul 31 (52%, Santa Catarina 14 (23%, Paraná 11 (18%, and Mato Grosso do Sul 4 (7%. Positive anti-IA IHC labelling was observed in 45% of the cases, which were associated with necrotizing bronchiolitis, atelectasis, purulent bronchopneumonia and hyperemia. Moreover, type II pneumocyte hyperplasia, alveolar and bronchiolar polyp-like structures, bronchus-associated lymphoid tissue (BALT hyperplasia and pleuritis were the significant features in negative anti-IA IHC, which were also associated with chronic lesions. There were only two cases with positive anti-PCV2 IHC and none to PRRSV. Therefore, SIV was the predominant infectious agent in the lung samples studied. The viral antigen is often absent due to the rapid progress of SI, which may explain the negative IHC results for IA (55%; therefore, IHC should be performed at the beginning of the disease. This study

  20. Macroscopic and microscopic examination of pulmonary Crenosoma striatum in hedgehog. (United States)

    Naem, S; Tavakoli, M; Javanbakht, J; Alimohammadi, S; Farshid, A A; Mohammad Hassan, M A


    The aim of study was to necropsy and histopathology evaluation of lung Crenosoma striatum in hedgehog. In July 2012, 10 porcupines were collected from Urmia city and transferred to parasitology lab of the veterinary faculty where they were euthanized by ketamine (over 40-90 mg/kg) intraperitoneally. In this study the lungs were assessed through naked eyes regarding parasite presence upon washing. The lung tissue was examined under loop microscope in order to finding small worms in lung parenchyma. The worms were removed by Anse forceps and kept in AFA solution, and collected for diagnosis. In order to carrying out pathological tests, some samples prepared and placed in formalin 10 % for fixation. The counted worms frequency in high severe and moderate lungs were as 86 (50 females and 36 males) and 19 (13 females and 16 males) worms respectively. But no worms were observed in healthy lungs. The infestation severity was as; low infestation (1-7 worms), moderate infestation (8-20), severe infestation (21-50) and very severe infestation (more than 50 worms). The lung examinations of non-infested lungs indicated that the lung tissues had no parasite. In addition, no inflammation reactions as inflammatory cells presence were observed, and the air spaces with alveoles' wall in some regions were observable. On histopathological examination, the observed alteration was primarily inflammatory changes, and in some cases the proliferation was also observable. Hyperemia and inflammatory cell infiltration, somehow the alveolar space was filled, representing bronchopneumonia reaction. The bronchioles had various changes as hypertrophy and hyperplastic in different parts of respiratory system. Hyperemia and hemorrhage were very severe in some cases caused hemosiderosis in the lung. In severe inflammations the pneumonia along with increasing of bronchial cells in the lumen rose as well, leading to severe verminous infestation of the lung. In regard to the obtained results, the

  1. Bovine viral diarrhoea, bovine herpesvirus and parainfluenza-3 virus infection in three cattle herds in Egypt in 2000. (United States)

    Aly, N M; Shehab, G G; Abd el-Rahim, I H A


    This study reported field outbreaks of bovine viral diarrhoea virus (BVDV) infection, either alone or mixed with bovine herpesvirus-1 (BHV-1) and/or parainfluenza-3 virus (PI-3V) in Egypt during 2000. In Lower Egypt, young calves in three cattle herds in El-Minufiya Province, El-Fayoum Province and in governmental quarantine in El-Behira Province, showed symptoms of enteritis, either alone or accompanied by respiratory manifestations. The affected herds were visited and the diseased animals were clinically examined. Many epidemiological aspects, such as morbidities, mortalities and case fatalities, as well as the abortive rate, were calculated. Ethylenediamine tetra-acetic acid-blood samples, sterile nasal swabs and serum samples were obtained for virological and serological diagnosis. The laboratory investigations revealed that the main cause of calf mortalities in the three herds was infection with BVDV, either alone, as on the El-Minufiya farm, or mixed with PI-3V, as on the El-Fayoum farm, or mixed with both BHV-1 and PI-3V, as in the herd in governmental quarantine in El-Behira Province. A total of nine dead calves from the three herds were submitted for thorough post-mortem examination. Tissue samples from recently dead calves were obtained for immunohistochemical and histopathological studies. The most prominent histopathological findings were massive degeneration, necrosis and erosions of the lining epithelium of the alimentary tract. Most of the lymphoreticular organs were depleted of lymphocytes. In pneumonic cases, bronchopneumonia and atypical interstitial pneumonia were evident. The present study suggested that the immunosuppressive effect of BVDV had predisposed the animals to secondary infection with BHV-1 and PI-3V. This study concluded that concurrent infection with BVDV, BHV-1 and PI-3V should be considered as one of the infectious causes of pneumoenteritis and, subsequently, the high morbidities and mortalities among young calves in Egypt

  2. Anthrax - past, present and future

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    Madle-Samardžija Nadežda D.


    Full Text Available History Anthrax has been known since ancient times. Besides some references in the Old Testament, there is evidence of plagues in ancient Egypt, as well as descriptions of the disease by the Roman poet Virgil. Etiology Anthrax is caused by Bacillus anthracis, unmovable, aerobic, gram-positive rods. It forms spores, which can survive for years in the environment. Pathogenesis Capsular polypeptide and anthrax toxin are the principal virulence factors of Bacillus anthracis. Anthrax toxin consists of three proteins called protective antigen, edema factor, and lethal factor. It is thought that the inflammatory mediator - lethal factor is stored within the macrophage during the early stage of infection. It is rapidly released in large amounts into the blood stream and once the threshold for lysis is reached, it may be the cause of sudden death. Epidemiology Grass-eating animals are usually infected by the bacilli from grass and ground. The disease is transmitted to people by contact with the sick animals or their products, such as wool skin, meat etc. Clinical features Two clinical forms exist: outer cutaneous and inner, including inhalation and gastrointestinal anthrax. While cutaneous anthrax is easily cured, the inner forms have high mortality rates. Diagnosis and differential diagnosis The diagnosis is easily established in cutaneous cases, characterized by black eschar. Severe intoxication and collapse during the course of bronchopneumonia or hemorrhagic enteritis should arise suspicion of anthrax. Therapy Hospitalization of patients is mandatory. Bacillus anthracis is susceptible to a number of antibiotics, including penicillin, erythromycin tetracyclines, cephalosporins etc. Prevention General veterinary prevention including vaccination of livestock and control of products is very important. The vaccine consists of anthrax bacillus that is attenuated. The endangered population, such as animal workers and military personnel should be vaccinated

  3. Efficacy and safety of open-label etanercept on extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis and psoriatic arthritis: part 1 (week 12) of the CLIPPER study (United States)

    Horneff, Gerd; Burgos-Vargas, Ruben; Constantin, Tamas; Foeldvari, Ivan; Vojinovic, Jelena; Chasnyk, Vyacheslav G; Dehoorne, Joke; Panaviene, Violeta; Susic, Gordana; Stanevica, Valda; Kobusinska, Katarzyna; Zuber, Zbigniew; Mouy, Richard; Rumba-Rozenfelde, Ingrida; Breda, Luciana; Dolezalova, Pavla; Job-Deslandre, Chantal; Wulffraat, Nico; Alvarez, Daniel; Zang, Chuanbo; Wajdula, Joseph; Woodworth, Deborah; Vlahos, Bonnie; Martini, Alberto; Ruperto, Nicolino


    Objective To investigate the efficacy and safety of etanercept (ETN) in paediatric subjects with extended oligoarticular juvenile idiopathic arthritis (eoJIA), enthesitis-related arthritis (ERA), or psoriatic arthritis (PsA). Methods CLIPPER is an ongoing, Phase 3b, open-label, multicentre study; the 12-week (Part 1) data are reported here. Subjects with eoJIA (2–17 years), ERA (12–17 years), or PsA (12–17 years) received ETN 0.8 mg/kg once weekly (maximum 50 mg). Primary endpoint was the percentage of subjects achieving JIA American College of Rheumatology (ACR) 30 criteria at week 12; secondary outcomes included JIA ACR 50/70/90 and inactive disease. Results 122/127 (96.1%) subjects completed the study (mean age 11.7 years). JIA ACR 30 (95% CI) was achieved by 88.6% (81.6% to 93.6%) of subjects overall; 89.7% (78.8% to 96.1%) with eoJIA, 83.3% (67.2% to 93.6%) with ERA and 93.1% (77.2% to 99.2%) with PsA. For eoJIA, ERA, or PsA categories, the ORs of ETN vs the historical placebo data were 26.2, 15.1 and 40.7, respectively. Overall JIA ACR 50, 70, 90 and inactive disease were achieved by 81.1, 61.5, 29.8 and 12.1%, respectively. Treatment-emergent adverse events (AEs), infections, and serious AEs, were reported in 45 (35.4%), 58 (45.7%), and 4 (3.1%), subjects, respectively. Serious AEs were one case each of abdominal pain, bronchopneumonia, gastroenteritis and pyelocystitis. One subject reported herpes zoster and another varicella. No differences in safety were observed across the JIA categories. Conclusions ETN treatment for 12 weeks was effective and well tolerated in paediatric subjects with eoJIA, ERA and PsA, with no unexpected safety findings. PMID:23696632

  4. Feasibility of full and rapid neuromuscular blockade recovery with sugammadex in myasthenia gravis patients undergoing surgery – a series of 117 cases

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    Vymazal T


    Full Text Available Tomas Vymazal,1 Martina Krecmerova,1 Vladimír Bicek,1 Robert Lischke2 1Department of Anaesthesiology and ICM, 2nd Faculty of Medicine, 23rd Surgical Department of 1st Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic Purpose: Myasthenia gravis (MG is an autoimmune disease interfering with neuromuscular transmission. Patients are at risk of postoperative residual curarization (PORC if nondepolarizing muscle relaxants are used. Clinically inapparent insufficient muscle strength may result in hypoventilation and postoperative bronchopneumonia. We describe a cohort of 117 cases in which sugammadex was used in MG patients undergoing surgery with muscle relaxation with rocuronium.Methods and patients: We anesthetized 117 patients with MG using rocuronium and sugammadex as neuromuscular blockade reversal agent. One hundred five patients underwent surgical thymectomy and 12 underwent cholecystectomy (five laparotomic and seven laparoscopic. We measured time from sugammadex administration to recovery and to extubation, using the TOF-Watch® (series of four consecutive electrical impulses [the train-of-four] >0.9. We tracked peripheral capillary oxygen saturation (SpO2 <95%, elevation of partial pressure of carbon dioxide (pCO2 >10% above baseline, number of reintubations within the first 48 hours, and number of pneumonias within 120 hours, postoperatively. Results were processed as average, minimum, and maximum values.Results: The period needed to reach train-of-four of 0.9 following sugammadex administration was on average 117 seconds (minimum of 105 seconds/maximum of 127 seconds and differed within deviation <10%. The time to extubation following sugammadex administration was on average 276 seconds (minimum of 251 seconds/maximum of 305 seconds and differed minimally among patients as well. We observed no SpO2 <95%, no pCO2 elevation >10% above a baseline, no emergent reintubation within the

  5. 改良口罩在患儿雾化吸入中的应用%The Applying of Improved Respirator in Children with Inhalation Therapy

    Institute of Scientific and Technical Information of China (English)

    唐云; 马燕燕


    Objective Prevention the occurrence of adverse reaction of facial atomization inhalation of children.Methods Totally,100 children with bronchopneumonia (n=65) or bronchiolitis (n=35) were randomized divided into the improved group (n=54) and the control group(n=46).The improved group worn the cotton respirator with cartoon pattern which was cut into hollow in the nose whereas the control group worn conventional nebulizer mask. Results The prevalence of facial ad-verse reaction of the improved group was significantly lower than the control group (P0.05).Conclusion Improved respirator could decrease facial adverse reaction effectively when applying to children with inhalation therapy.%目的:预防雾化吸入患儿面部不良反应的发生。方法将2013年3月—2013年9月100例支气管肺炎和喘息性支气管炎患儿(其中支气管肺炎65例、喘息性支气管炎35例)随机分为改良组54例、对照组46例,改良组将印有卡通图案的棉质口罩中间口鼻处,剪成镂空状佩戴,再戴雾化面罩;对照组按常规直接戴雾化面罩,分析对比两组患者发生不良反应的几率及治疗时间的比较。结果改良组面部不良反应(面部潮红、皮疹)发生率显著低于对照组(P<0.05);两组雾化吸入每天使用时间和积累使用时间比较,差异无统计学意义(均P>0.05)。结论在临床的实际运用中,通过对传统口罩的改良,可有效预防因雾化吸入而造成面部过敏等不良反应的发生,且不会增加治疗的时间,安全可靠,值得临床运用与推广。


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    Sunil Dutt


    Full Text Available BACKGROUND : Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. The organism is transmitted during the bite of trombiculid mites. Field rodents are the reservoir hosts. The disease is endemic in many parts of India including the stat e of Jammu and Kashmir but is often under reported due to lack of diagnostic facilities. AIM: The aim was to study the clinical and epidemiological profile of pediatric scrub typhus patients reporting to the Department of Pediatrics, Government Medical College Jammu, a referral hospital for whole of Jammu region. METHODS : Prospective study conducted in the Department of Pediatrics Govt . Medical College Jammu from January 2011 to December 2011. A total of 90 children who reported with fever and rash or ly mphadenopathy or both were tested using qualitative ELISA for IgM antibodies against Orientia tsutsugamushi . The clinical and epidemiological profile of 74 pediatric scrub typhus patients who tested positive for IgM ELISA for Scrub typhus was studied. OBSE RVATION: Most ( 71.6% patients were in the age group of 6 - 15 years. 83% of them reported in the months of September and October. One third of the patients belonged to Rajouri district. Common physical signs were fever ( 100%, rash ( 86.4% and generalised l ymphadenopathy ( 83.7%. Others included conjuctival congestion ( 44.59%, hepatosplenomegaly ( 36.48%, jaundice ( 22.97%, edema ( 18.91%, eschar ( 17.56%, meningeal signs ( 10.81%, and myocarditis ( 5.4%.Most of the children presented late with complication s like hepatic dysfunction ( 55.4% , renal dysfunction ( 24.32 %, shock ( 4% meningoencephalitis ( 9.4%, gastrointestinal haemorrhage ( 8.1% and myocarditis ( 4.05 % , bronchopneumonia ( 4.05% and multiorgan involvement ( 2.7%. Children were treated with chloramphenicol or doxycycline. There was no mortality in the study group. CONCLUSION: Scrub typhus is endemic in the Jammu region especially Nowshera - Sunderbani - Rajouri belt

  7. Reduction of group A beta-hemolytic streptococcus pharyngo-tonsillar infections associated with use of the oral probiotic Streptococcus salivarius K12: a retrospective observational study

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    Gregori G


    Full Text Available Giuseppe Gregori,1 Ornella Righi,1 Paolo Risso,2 Goffreda Boiardi,1 Giovanni Demuru,1 Anna Ferzetti,1 Antonio Galli,1 Marco Ghisoni,1 Sonia Lenzini,1 Claudio Marenghi,1 Caterina Mura,1 Roberto Sacchetti,1 Lucia Suzzani1 1Primary Care Department, Local Health Unit (ASL, Piacenza, 2Department of Health Science (DISSAL, University of Genoa, Genoa, Italy Abstract: Recurrent pharyngo-tonsillar infections caused by group A beta-hemolytic streptococci (GABHS occur frequently in young children, and the treatment of these infections contributes substantially to the total current requirement for antibiotic prescribing. Our study goal was to assess through a retrospective observational analysis whether the administration of the oral probiotic, Streptococcus salivarius K12 (SsK12, could reduce the occurrence of GABHS pharyngo-tonsillar infections in children who had a recent history of recurrent episodes of these infections. Twelve primary care pediatricians identified, through their databases, a total of 130 children who had experienced recurrent GABHS pharyngo-tonsillar infections over a period of at least 6–12 months prior to their inclusion in the study. Of these children, 76 then undertook a 90-day program requiring once-a-day dosing with a commercially available (Bactoblis lozenge containing SsK12. No probiotic supplement was given to the remaining 54 (control children. Each subject was monitored for the occurrence of GABHS pharyngo-tonsillitis and also for acute otitis media, bronchitis, sinusitis, and bronchopneumonia for at least 12 months following their entry to the study. Even 9 months after the use of SsK12 had been stopped, the probability of new GABHS infections was significantly lower (P>0.001 when compared to the period before dosing commenced. When compared to the untreated children, those taking SsK12 appear to have had significantly fewer GABHS infections both during the 90-day period of prophylaxis and during the following 9

  8. Impella 5.0 Support in INTERMACS II Cardiogenic Shock Patients Using Right and Left Axillary Artery Access. (United States)

    Schibilsky, David; Lausberg, Henning; Haller, Christoph; Lenglinger, Matthias; Woernle, Barbara; Haeberle, Helene; Rosenberger, Peter; Walker, Tobias; Schlensak, Christian


    The catheter-based Impella 5.0 left ventricular assist device (LVAD) is a powerful and less invasive alternative for patients in cardiogenic shock. The use of this device as a primary mechanical circulatory support strategy in INTERMACS II patients should be evaluated. From April 2014 to August 2014, eight Impella 5.0 devices were implanted in seven patients via the axillary artery access (six right and two left). We analyzed the outcome of the four patients in whom the Impella 5.0 device was implanted for the purpose of primary stabilization of cardiogenic shock (INTERMACS II). The remaining three patients had a contraindication for a permanent LVAD and received the device for prolonged weaning from extracorporeal life support (ECLS) system. The implantation of the Impella 5.0 was technically successful in all patients and resulted in the stabilization of the clinical situation. All four patients could be bridged to a long-term device (n = 3) or to cardiac recovery (n = 1). In one patient, 2 days of ECLS support was necessary because of pump thrombosis after 31 days of Impella 5.0 support. One patient with bronchopneumonia had the Impella 5.0 exchanged from the right to the left axillary artery after 22 days of support because of the progressive loss of purge flow and the need for longer bridging to a permanent LVAD. The last patient was supported for giant-cell myocarditis for 22 days and bridged to cardiac recovery. All patients were transferred to the intensive care unit with the Impella device in place. In INTERMACS II situations, the implantation of the Impella 5.0 via the right or left axillary access allowed additional time for decision making. Early patient mobilization, including walking with the Impella device in place, optimized the conditions for either weaning or the implantation of a permanent LVAD. This novel technique of left axillary approach leads to more flexibility in the case of anatomical- or device-related contraindications to right

  9. 小儿常见急性感染性疾病红细胞免疫功能%Exploration of red cell immune function in children with acute infections diseases

    Institute of Scientific and Technical Information of China (English)

    刘玉峰; 曾利; 伍学强; 巢燕语; 杨瑞; 谢健; 袁玉


    目的: 探讨急性感染性疾病状态下的患儿红细胞免疫功能的变化及意义。方法: 测定红细胞免疫功能,红细胞免疫功能指标包括:红细胞C3b受体(RBC-C3bR)、红细胞免疫复合物花环(RBC-ICR)、红细胞免疫促进因子和抑制因子等。结果: 急性感染患儿RBC-C3bR和促进因子均明显低于正常对照(P<0.01);RBC-ICR除腹泻组外,其余两组显著降低(P<0.01);红细胞免疫抑制因子均绝对或相对升高。结论: 急性感染性疾病时患者红细胞免疫功能受抑制或处于失代偿状态。%Objective: To explore the changes of red cell immunonity in children with acute infectious diseases.Methods: The RBC-C3b receptor (RBC-C3bR)、RBC immunocomplex(RBC-ICR)、the rosette fomation of the RBC promotive factors and inhibitory factors were detected.Results: The RBC-C3bR、RBC-ICR and RBC-ICR promotive factors in children with AURI and caute broncho-pneumonia are lower than that of normal(P<0.01),and the inhibitory factors are the same as normal(P>0.05).the RBC-C3bR,promotive factors in children with acute infectious diarrhea are lower than that of normal(P<0.01).inhibitory factor in children with acute infectious diarrhea are highter than that of normal(P<0.05).Conclusion: It is indicated that the red cell immune function in children with acute infectious diseases are decreased.

  10. Systemic Actinomyces infection. A potential complication of intrauterine contraceptive devices. (United States)

    de la Monte, S M; Gupta, P K; White, C L


    Infections caused by Actinomyces organisms have been demonstrated to occur in association with IUD use. Uterine actinomycosis infection is usually superficial, but it is potentially invasive. It may prove fatal. When Actinomyces is detected in a vaginal Papanicolaou smear, establishment of the correct diagnosis followed by IUD removal and appropriate antibiotic therapy are recommended. A case history is presented of a 28 year old woman who had been using an IUD and who had systemic Actinomyces infection and a brain abscess develop several years after removal of her uterus and fallopian tubes. The woman was referred to the Johns Hopkins Hospital in Baltimore in 1977 for evaluation of headaches and grand mal seizures. 4 years earlier, in 1973, she had been seen at another hospital with a recent weight loss of 18 kg. She was found to have a tubo-ovarian abscess, for which she underwent a hysterectomy, bilateral salpingectomy, and unilateral oophorectomy. At the time of surgery, an IUD was in place. A histopathological diagnosis of botryomycosis tubo-ovarian abscess was made on submitted tissues. She received no antibiotic therapy. In 1975, pulmonary infiltrates developed that were attributed to bronchopneumonia. She was treated with a short course of tetracycline hydrochloride. Later that year she was thought to have sarcoidosis and was treated for 1 year with several doses of prednisone. Clinically, her condition remained stable until March 1977, when a pyogenic subcostal abscess was drained. In July 1977, she had headache, dizziness, generalized seizures, and an incomplete right homonymous hemianopsia develop. A craniotomy for excision and drainage of an abscess was performed. The presence of Actinomyces israelii in brain tissue was confirmed by direct immunoflourescence using specific antiserum. It was confirmed that Actinomyces had been present at the time of her 1st surgical procedure. She was treated with high doses of intravenous penicillin G potassium for the

  11. Repouso da junção neuromuscular no tratamento de crises miastênicas e colinérgicas Management of the myasthenic and cholinergic crisis by neuromuscular junction rest

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    J. Lamartine de Assis


    second group, in addition to this management, were submitted to prolonged curarization by galamine (Flaxedil by intramuscular injection; all of them presented an initial curare supersensitivity which always decreased shortly. In both methods the reinstitution of the drug therapy was progressive. The respirator weanned of progressively and the patients were kept under observation for adequate ventilation. The doses were variable but subsequent doses of antimyasthenic medications were determined by clinical findings and response to the tensilon or prostigmine tests. The doses were increased or decreased accordingly in each individual case, rapid changes of drug doses to perfect adjustment being undesirable in this transition period. Partial or temporary remission occurred in some patients. Others were able to sustain satisfactory ventilation for a long period or definitively. Most of the crisis improved and most of the patients benefited from the therapeutic method of the neuromuscular junction rest. There was a remarkable reduction in the mortality rate from the crisis. One patient had a thymoma which was malignant; in spite of this the evolution of this case has been good after the treatment. Those patients who had immediate good response to the treatment of the crisis had a favorable fellow up, even a complete remission. Respiratory infections were very common in spite of all cares. Culture of tracheal secretions and wound exsudates were made. Bactericidal and broad-spectrum antibiotics were used, depending of the laboratory report cf patient's sensitivity. Physiotherapy besides other prophylactic measures was used against bronchopneumonia. Atelectasis was a common complication in the crisis and all efforts to prevent it were made, including daily clinical examination of pulmonary conditions, Vt,, blood pressure and bed side chest films. The routine use of atropine sulfate promoved inspissation of bronchial secretions, plugging of the bronchi, and attendant atelectasis

  12. Meta analysis of the risk factors of recurrent wheezing in infants%婴幼儿反复喘息危险因素Meta分析

    Institute of Scientific and Technical Information of China (English)

    单文婕; 卢燕鸣; 李亚琴; 徐凌云; 曹兰芳


    Obgective To analyze the relevant risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life.Methods "Wheezing,respiratory sounds,risk factor" were used as key words to retrieve papers in Chinese literature databases including Sinomed,Wanfang and Weipu databases.The same strategy was used to retrieve English papers in English literature databases including PubMed,Cochrane library and Embase.Time range was from 31th May 2004 to 1 rd June 2014.The execution of quality evaluation of the included documents was in compliance with Newcastle-Ottawa Scale and cross-sectional study standard recommended by Agency for Healthcare Research and Quality.The evidence quality evaluation was conducted with GRADEpro and followed by the Meta analysis with RevMan 5.2.R~ults A total of 13 studies were included in this Meta-analysis.Several factors were related to recurrent wheezing episodes,including risk factors such as maternal smoking during pregnancy (OR =1.47,95% CI:1.30-1.66),asthma in parents (OR =1.94,95 % CI:1.72-2.19),family history of atopy (OR =1.94,95% CI:1.72-2.19),male (OR =1.42,95 % CI:1.19-1.69),history of eczema (OR =2.36,95 % CI:1.69-3.30),colds (> 6 times) (OR =2.02,95 % CI:1.54-2.64),history of bronchopneumonia (OR =1.85,95 % CI:1.46-2.34),exposure to cigarette smoking(OR =2.30,95% CI:1.68-3.14),daycare attendance(OR =2.27,95% CI:1.97-2.60);Education received by the mother > 12 years (OR =0.80,95% CI:0.70-0.92) was the protective factor.Conclusions The risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life are maternal smoking during pregnancy,asthma in parents,family history of atopy,male,history of eczema,colds (> 6 times),history of bronchopneumonia,exposure to cigarette smoking and daycare attendance.The protective factor is education received by the mother ≥ 12 years.The prerequisite in precaution of infants recurrent wheezing is to ensure the utmost avoidance of hazardous factors and

  13. Doenças de ovinos diagnosticadas no Laboratório de Anatomia Patológica Animal da Universidade Federal de Mato Grosso do Sul (1996-2010 Sheep diseases diagnosed at the Laboratory of Animal Pathology, Federal University of Mato Grosso do Sul, Brazil (1996-2010

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    Thiago L. Almeida


    compile data and perform retrospective studies to provide important insight for professionals. A prevalence study from January 1996 to December 2010 was carried out in the archives of Laboratório de Anatomia Patológica Animal (LAP, Universidade Federal de Mato Grosso do Sul (UFMS. Laboratório de Bacteriologia, UFMS, and Setor de Patologia Veterinária at Universidade Federal do Rio Grande do Sul helped on the diagnostic of pulmonary mannheimiosis and scrapie respectively. The reports for sheep were reviewed and grouped into conclusive and inconclusive ones. The conclusive cases were classified according to the etiology of the disease. In the period, 331 exams (3.97% were done. Sixty-four experimental cases and materials from other states or countries (19.3% were excluded. Remaining cases (267, eighty-seven (32.6% were inconclusive and 180 (67.4% were considered conclusive reports, were classified according to the etiology: 60 (33.3% infectious and parasitary diseases; 45 (25% were poisonings and toxi-infections; 41 (22.8% were summarized as "injuries without apparent cause"; 22 (12.2% cases of metabolic and nutritional diseases; 10 (5.6% were classified as "other disorders" and 2 (1.1% case of neoplasms. Haemonchosis, fibrinonecrotic or fibrinopurulent pleuropneumonia, bronchopneumonia and pneumonia, poisonings by Brachiaria spp. and copper poisoning were the most prevalent diseases in sheep. Two cases of scrapie have been diagnosed in this period.

  14. Multiple myeloma invasion of the central nervous system

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    Marjanović Slobodan


    Full Text Available Introduction. Multiple myeloma (MM is characterized by the presence of neoplastic proliferating plasma cells. The tumor is generally restricted to the bone marrow. The most common complications include renal insufficiency, hypercalcemia, anemia and reccurent infections. The spectrum of MM neurological complications is diverse, however, involvement of MM in the cerebrospinal fluid (CSF and leptomeningeal infiltration are rare considered. In about 1% of the cases, the disease affects the central nervous system (CNS and presents itself in the form of localized intraparenchymal lesions, solitary cerebral plasmocytoma or CNS myelomatosis (LMM. Case report. We presented the clinical course of a 55-year-old man with MM and LMM proven by malignant plasma cells in the CSF, hospitalized with the pain in the thoracic spine. His medical history was uneventful. There had been no evidence of mental or neurological impairment prior to the seizures. Physical examination showed no abnormalities. After a complete staging, the diagnosis of MM type biclonal gammopathia IgG lambda and free lambda light chains in the stage III was confirmed. The treatment started with systemic chemotherapy (with vincristine, doxorubicin plus high-dose dexamethasone - VAD protocol, radiotherapy and bisphosphonate. The patient developed weakness, nausea, febrility, dispnea, bilateral bronchopneumonia, acute renal insufficiency, confusions, headaches and soon thereafter sensomotor aphasias and right hemiparesis. The patient was treated with the adequate therapy including one hemodyalisis. His neurological status was deteriorated, so Multislice Computed Tomography (MSCT of the head was performed and the findings were normal. Analysis of CSF showed pleocytosis, 26 elements/ mL and increased concentrations of proteins. Cytological analysis revealed an increased number of plasma cells (29%. Electrophoretic analysis of proteins disclosed the existance of monoclonal components in the serum

  15. 新护理模式下在小儿支气管肺炎中的综合效果分析%The New Nursing Mode Analysis of Comprehensive Effect in Children With Bronchial Pneumonia

    Institute of Scientific and Technical Information of China (English)

    张清华; 王启顺


    目的:研究分析新护理模式下在小儿支气管肺炎中的综合效果。方法选取2016年1~6月我院儿科收治的115例支气管肺炎的患儿为本次研究对象,同时选取2015年1~12月收治的97例支气管肺炎的患儿为对照组。对比新护理模式与之前未开展时期护理效果比较。结果经护理干预后,观察组患儿的护理总有效率占94.78%,高于对照组患儿的护理总有效率85.57%,差异有统计学意义,P<0.05。经护理后,观察组患儿家长护理满意度为97.39%,对照组患儿家长护理满意度为89.69%,观察组患儿的家长护理满意度高于对照组,P<0.05,具有统计学意义。结论新护理模式下在小儿支气管肺炎中的综合效果显著,护理效果明显提高,患儿家长的护理满意度提高。%Objective To study the new nursing mode in the comprehensive effect of bronchial pneumonia in children.Methods From January to June 2016,115 cases of children with bronchial pneumonia admitted in our hospital pediatric as the study object,and January to December 2015,97 cases of children with bronchial pneumonia as the control group. Contrast the new nursing mode period nursing effect compared with before.ResultsAfter nursing intervention,the observation group with nursing total effective rate was 94.78%, total effective rate was 85.57%,significantly higher than the control group of children with care significant difference,P<0.05. After nursing,the observation group of parents care satisfaction was 97.39%,the control parents care satisfaction was 89.69%,the children of parents care satisfaction observation group was obviously higher than that of control group,P<0.05,with statistical significance. ConclusionThe new nursing mode in children with bronchopneumonia effect is remarkable,nursing effect is improved obviously and the nursing satisfaction of parents is greatly increased.

  16. Alterações histopatológicas pulmonares em pacientes com insuficiência respiratória aguda: um estudo em autopsias Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

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    Alexandre de Matos Soeiro


    patients with acute respiratory failure (ARF and determine whether underlying diseases and certain associated risk factors increase the incidence of these histopathological patterns. METHODS: Final autopsy reports were reviewed, and 3030 autopsies of patients > 1 year of age with an underlying disease and associated risk factors were selected. All had developed diffuse infiltrates and died of ARF-related pulmonary alterations. RESULTS: The principal pulmonary histopathological alterations resulting in immediate death were diffuse alveolar damage (DAD, pulmonary edema, lymphocytic interstitial pneumonia (LIP and alveolar hemorrhage. The principal underlying diseases were AIDS, bronchopneumonia, sepsis, liver cirrhosis, pulmonary thromboembolism, acute myocardial infarction (AMI, cerebrovascular accident, tuberculosis, cancer, chronic kidney failure and leukemia. The principal associated risk factors were as follows: age > 50 years; arterial hypertension; congestive heart failure; chronic obstructive pulmonary disease; and diabetes mellitus. These risk factors and AIDS correlated with a high risk of developing LIP; these same risk factors, if concomitant with sepsis or liver cirrhosis, correlated with a risk of developing DAD; thromboembolism and these risk factors correlated with a risk of developing alveolar hemorrhage; these risk factors and AMI correlated with a risk of developing pulmonary edema. CONCLUSION: Pulmonary findings in patients who died of ARF presented four histopathological patterns: DAD, pulmonary edema, LIP and alveolar hemorrhage. Underlying diseases and certain associated risk factors correlated positively with specific histopathological findings on autopsy.

  17. Surto de Circovirose (Síndrome Definhante Multissistêmica de Suínos Desmamados no estado do Rio de Janeiro Outbreak of Circovirosis (Porcine Postweaning Multisystemic Wasting Syndrome in the state of Rio de Janeiro, Brazil

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    Ticiana do Nascimento França


    , decubitus and convulsions. The course of the disease was acute or subacute. The most important post-mortem findings were enlarged lymphnodes, non-collapsed lungs, with consolidated areas mainly in the cranial lobes. Histological lesions consisted mainly of lymphohistiocytic infiltration with multinucleate giant cells in lymph nodes, spleen, Peyer's patches, kidney, lung and liver, depletion or lymphoid hyperplasia, as well as lymphohistiocytic interstitial pneumonia and areas of secondary bronchopneumonia. The diagnosis was established through observations of the symptoms and typical lesions, and was confirmed by immunohistochemical examination and PCR. The objective of this study was to characterize the epidemiological, clinical and pathological aspects of the outbreak of PMWS, because of the severe direct or indirect economical losses caused by the disease to the world pig industry.

  18. Infecção de prótese vascular em cirurgia da aorta torácica: revisão da experiência e relato de caso tratado por técnica não convencional Vascular prosthesis infection in thoracic aorta surgery: review of the experience and a case report illustrating treatment with an unconventional technique

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    Ronaldo Ducceschi Fontes


    Full Text Available Relatamos o caso de uma paciente de 37 anos de idade, que há cinco anos havia sido submetida à operação de Bental-de Bono em nosso serviço e retornou com dor de forte intensidade no toráx, sendo diagnosticada dissecção aguda de aorta do tipo III e tratada clinicamente. Um ano após esse episódio houve expansão dessa dissecção e a paciente foi submetida à cirurgia com interposição de prótese de dacron em aorta descendente. No pós-operatório imediato houve broncopneumonia esquerda e a paciente recebeu alta em boas condições e afebril. Após um mês da alta, retornou com febre e toxemia. Com diagnóstico de empiema pleural, foi submetida à toracotomia exploradora que não confirmou esse diagnóstico, havendo apenas intenso espessamento pleural. Quatro meses após a toracotomia exploradora, foram isolados Klebsiella pneumoniae e Enterobacter sp na hemocultura. A ressonância magnética revelou imagens compatíveis com infecção peri-prótese. Com esse quadro clínico e laboratorial foi indicada a remoção do enxerto e derivação axilo-bifemoral. A operação foi realizada com sucesso, a paciente recebeu alta em boas condições e continua fazendo controle ambulatorial e, atualmente, encontra-se com 57 meses de evolução sem complicações. São discutidos os métodos empregados para o diagnóstico e tratamento da infecção de prótese na cirurgia da aorta torácica.We report the case of a 37-year-old-female patient who had undergone a Bentall procedure at our service and returned with intense chest pain and acute aortic dissection type III, which was diagnosed and clinically treated. One year after this episode, this dissection expanded, and the patient underwent surgery with interposition of a Dacron graft in the descending aorta. In the immediate postoperative period, the patient experienced left bronchopneumonia and was discharged afebrile and in good condition. One month after discharge, she returned with fever and

  19. Clinical analysis of the first Uyghur case of Bardet-Biedl syndrome in southern Xinjiang%南疆首例维吾尔族 Bardet-Biedl 综合征患儿诊治分析

    Institute of Scientific and Technical Information of China (English)

    伊鹏; 刘虹; 买合木提江买买提; 赛排尔江艾尼; 牛会林


    Objective To investigate the clinical characteristics of the first Uyghur case of Bardet-Biedl syndrome in southern Xinjiang,and summarize the experiences on diagnosis and therapy. Methods The data on medical history,physical examination,laboratory examination and imaging examination were collected.Department of pediatrics,orthopedics,anesthesiol-ogy,ophthalmology,stomatology and radiology all took part in the consultation. Results After multi-discipline consultation, the child was proved to be suffered with bronchopneumonia,obesity,mental retardation,absence of 1 2,22,32,42 incisors,DⅠdeciduous tooth retention,Polydactyly (six fingers)of both hands and feet,microcaulia,night blindness,retinitis pigmento-sa,and high myopia. Conclusion Based on the history and clinical presentation,the child was diagnosed with Bardet-Biedl syndrome.After retrieving literature database in English and Chinese,we found out that there is no report on Bardet-Biedl syn-drome in southern Xinjiang previously.Thus,we report the first Uyghur case of Bardet-Biedl syndrome in this area.Nowadays, there is no method to cure this disease totally,and symptomatic treatment could improve the patient's living condition partially.%目的:调查分析南疆首例维吾尔族 Bardet-Biedl 综合征患儿的临床特点,总结诊治经验。方法对患儿进行病史采集,体格检查,实验室检查,影像学检查等,请儿科,骨外科,麻醉科,眼科,口腔科,放射科等多学科联合会诊以协助诊断。结果多科会诊后确定患儿存在支气管肺炎,肥胖,智力低下,12,22,32,42切牙缺失,DⅠ乳牙滞留,双手6指畸形,双足6趾畸形,阴茎短小,夜盲,视网膜色素变性,高度近视等问题。结论患儿确诊为 Bardet-Biedl 综合征,检索中外文文献,南疆地区未见本病的报道。我们首次在南疆地区报道了罕见的 Bar-det-Biedl 综合征患儿。目前该病尚无根治方法,主要给以

  20. Melioidosis in Malaysia: A Review of Case Reports (United States)

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini


    Background Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. Objective We sought to review case reports of melioidosis from Malaysia. Methods We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Results Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24–48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common—genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of

  1. Intoxicação natural por Amaranthus spinosus (Amaranthaceae em ovinos no Sudeste do Brasil Amaranthus spinosus (Amaranthaceae poisoning in sheep in southern Brazil

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    Paulo Vargas Peixoto


    streaks extending from cortex to medulla, and congestion. Histologically there was a severe acute tubular nephrosis, dispersed foci of coagulative necrosis in the liver, areas of coagulative necrosis in the myocardium and acute incipient interstitial pneumonia as well as secondary bronchopneumonia. Myocardial coagulative necrosis observed in seven sheep was attributed to hyperkalemia secondary to renal insufficiency. No references to spontaneous A. spinosus poisoning in sheep was found in the literature. Attempt to reproduce the poisoning by administration of the plant to sheep was insuccessful, probably because A. spinosus used was not from fertilized areas.

  2. Analysis of parainfluenza virus infection in hospitalized children in Nanjing%南京地区住院儿童副流感病毒感染监测

    Institute of Scientific and Technical Information of China (English)

    赵艳丰; 雷忠英; 王琳; 吕泰霞; 曾智凤; 陈炜钢; 张益红


    目的 监测南京地区儿童急性呼吸道副流感病毒感染的特征,了解副流感病毒流行情况,为临床诊治提供依据.方法 采集2009年3月至2012年2月住院的急性呼吸道感染患儿7830例鼻咽分泌物,用直接免疫荧光法检测呼吸道病毒,包括副流感病毒1、2及3型抗原(HPIV1、2、3)等.结果 7 830份标本中呼吸道病毒检出最高为呼吸道合胞病毒(RSV),达2 527例(占32.27%).副流感病毒病原检测阳性776例(总阳性率为9.91%),其中以副流感病毒3型为主,达504例,占副流感病毒检测阳性的64.95%;副流感病毒2型感染最少,仅44例占5.67%.副流感病毒检出率在婴儿组和幼儿组较高,分别为366例(46.86%)和249例(31.88%);春季检出率最高;所致疾病中以支气管肺炎最为多见.结论 南京地区住院儿童副流感病毒感染以HPIV3为主,婴儿感染率较高,儿童HPIV1、HPIV3病毒感染好发于春夏季节,HPIV2散发感染.%Objective To study features of human parainfluenza virus (HPIV) infection in children in Nanjing area. Methods The nasopharyngeal aspirate samples were obtained from 7830 children hospitalized with acute respiratory tract infection (ARI) from March 2009 to February 2012. Seven common respiratory viruses, including HPIV1, 2and 3 type antigens were detected by direct immunofliuorescence assay (DFA) in nasopharyngeal secretion. Results In 7830 cases, respiratory syncytial virus (RSV) was the most common respiratory virus found in 2327 infection cases (32.27%). The positive detectim rate of parainfluenza was 9.91%, 776 cases. In parainfluenza infection, HPIV3 is the most common, accounted for 504 cases (64.95%) and HPIV2 only for 44 cases (5.67%). The infants less than 1 year old and 1 to 3 years old had higher detection rate of parainfluenza viruses (46.86% and 31.88%, respectively). The highest positive rate was observed in children in spring and bronchopneumonia had the highest detection rate of viral

  3. Infecção natural por Listeria monocytogenes em cobaios Cavia porcellus Natural infection by Listeria monocytogenes in guinea pigs (Cavia porcellus

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    Hugo Henrique Ferreira


    infiltrates. Similar lesions were seen in the small intestine, cecum, and spleen of these two guinea pigs. The other two guinea pigs showed almost exclusively pulmonary changes that were characterized by diffuse red coloration and multifocal whitish areas in the pleural surface, which were microscopically associated with multifocal marked neutrophilic infiltrate within the alveolar and bronchiolar lumens, besides of interseptal and alveolar edema, vascular thrombi, and increased numbers of alveolar macrophages (suppurative pneumonia. The basophilic bacterial structures were Gram-positive for the Brown-Hopps special stain. The immunostaining antiListeria monocytogenes showed strong positive reactions in the necrotic foci of the liver, cecum, spleen, uterus, stomach, and mesenteric lymph node in the two guinea pigs with systemic listeriosis. The two guinea pigs with suppurative bronchopneumonia showed positive intense antiListeria monocytogenes immunostaining within the alveolar lumens. L. monocytogenes was isolated from samples of liver and rice hulls used as bedding material in the cages of the guinea pigs. It is suggested that the pulmonary changes observed here were caused by aspiration of particles of the rice hulls bedding contaminated with L. monocytogenes.

  4. Hidden intrahospital mortality for cerebro vascular diseases in the Intermediate Care Unit service. A five year period from 2000 to 2004. Mortalidad oculta intrahospitalaria por enfermedades cerebro vasculares en el Servicio de Terapia Intermedia. Quinquenio 2000-2004.

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    Julio Jova Hernández


    Full Text Available Introduction: mortality is one of the trustable and necessary indicator for the analysis of the sanitary situation of a community, and a data source that satisfies an ample cover that allows to define strategies in health actions upon a given population. Objective: to describe aspects related with hidden mortality by cerebrovascular diseases in Intermediate Care Unit. Method: Descriptive and retrospective study of a series of cases carried out during the period 2002-2004 in the hospital ¨Dr. Gustavo Aldereguía Lima¨ of Cienfuegos. All monthly reports of the cerebrovascular diseases attention group were analysed, these being gathered from digitalized data bases from the Hospital Statistics Department (n=3477. An enquiry was applied to obtain information as: year and month of hospitalisation; egress state; decease place if in case; stay; and type of cerebrovascular disease. The deceased necropsy protocols were analysed. Results: The hidden mortality was of 0.05; the main causal entity was the cerebral infarction (71,87%, the behaviour was similar in the five years, the average stay of deceased patients in Intermediate Care Unity was of 4.2 days, and outside this Unity: 8.7 days. It was proved the reduced inn hospital hidden mortality caused by cerebrovascular diseases with lethality definition by these entities during the first days in progressive care. A reduced percent of patients died in other units where an average stay doubles that of the Intermediate Care Unit, and as the main cause: the polymorbility associated to bronchopneumonia. Fundamento:La mortalidad es uno de los indicadores confiables y necesarios para el análisis del estado sanitario de una comunidad y fuente de datos para satisfacer una amplia cobertura que permite definir estrategias en las acciones de salud sobre una población. Objetivo: Describir aspectos relacionados con

  5. Observation on the Clinical Effects of Probiotics in Preventing Antibiotic-associated Diarrhea in Children%微生态制剂预防婴幼儿抗生素相关性腹泻临床观察

    Institute of Scientific and Technical Information of China (English)

    左满凤; 舒琼璋; 董晶


    Objective: To observe the clinical effects of probiotics in preventing antibiotic-associated diarrhea (AAD). Methods; Randomly 142 cases of child inpatients with bronchopneumonia receiving antibiotic therapy were divided into two groups, 62 patients of control group, treated by common anti-infective therapy, while 80 patients of prevention group, except for above therapy, given live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines, ~ aged 6 months, 1 g/d, ~ aged 1 years, 2 g/d, ~ aged 3 years ,2-3 g/d, all 2 times each day, 7 ~ 10 days as a course of treatment. Then the diarrhea incidence rates of the two groups were compared and the levels of salivary secretary IgA (slgA) after treatment 1 week later were examined. Results; Twenty-three patients suffered from diarrhea in 62 patients of the control group (37. 10% ) , 13 patients suffered from diarrhea (16. 25% ) in 80 patients of the prevention group (t= 8.021, P0. 05). Conclusions; Probiotics can be used to prevent AAD in infants.%目的:观察微生态制剂预防婴幼儿抗生素相关性腹泻(AAD)的临床疗效.方法:将142例应用抗生素治疗的支气管肺炎患儿随机分为两组,对照组62例,给予常规抗感染治疗;预防组80例,在对照组常规抗感染治疗基础上加服枯草杆菌二联活菌颗粒.年龄<6月,1 g/d,~1岁,2 g/d,~3岁,2~3 g/d,均分为2次服用,疗程7~10 d.比较两组腹泻的发生率,观察两组患儿治疗1周后唾液分泌型IgA(sIgA)含量的变化.结果:对照组62例发生腹泻23例(37.10%),预防组80例发生腹泻13例(16.25%),两组比较差异有统计学意义(x2=8.021,P<0.01);发生腹泻次数对照组为(5.16+1.50) 次/d,预防组为(3.62±1.10)次/d,两组比较差异有统计学意义(t=3.231,P<0.01);腹泻平均持续时间对照组为(4.74±1.32)d,预防组(3.71±1.33)d,两组比较差异有统计学意义(t=2.248,P<0.05).治疗1周后,对照组唾液sIgA与

  6. Indicadores da evolução do paciente com paralisia cerebral e disfagia orofaríngea após intervenção terapêutica Evolution indicators of patients with cerebral palsy and oropharyngeal dysphagia after therapeutic intervention

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    Carolina Castelli Silvério


    Full Text Available OBJETIVO: Verificar a evolução na função de alimentação e estabilidade clínica de crianças com paralisia cerebral tetraparética espástica após intervenção terapêutica. MÉTODOS: Foram levantados em prontuário médico, antes e após a terapia, os dados de classificação da funcionalidade da alimentação (escala FOIS e grau de disfagia, consistências alimentares e sinais sugestivos de penetração e/ou aspiração laringotraqueal de 36 crianças com paralisia cerebral espástica. RESULTADOS: A maioria dos sujeitos alimentava-se com preparo especial, antes e após a intervenção, ocorrendo restrição de sólidos e líquidos no segundo momento. Houve diminuição da severidade da disfagia, redução de broncopneumonias e hipersecretividade pulmonar, aumento do peso e diminuição dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, exceto recusa alimentar e cianose. CONCLUSÃO: A intervenção fonoaudiológica, em conjunto com a equipe multidisciplinar em disfagia, promove maior funcionalidade da deglutição e diminuição dos sinais sugestivos de penetração e/ou aspiração traqueal, além de maior estabilidade clínica.PURPOSE: To verify the evolution in nutrition and clinical stability of children with spastic tetraparetic cerebral palsy, after therapeutic intervention. METHODS: Data from before and after the therapeutic process were raised from the medical records of 36 children with spastic cerebral palsy, regarding classification of functional oral intake (FOIS scale and degree of dysphagia, food consistency, and suggestive signs of penetration and/or tracheal aspiration. RESULTS: Most subjects were fed with special preparation, before and after intervention, with restrictions to solid and liquid foods in the second instance. It was observed decrease of the severity of dysphagia, reduction of the incidence of bronchopneumonia and pulmonary hypersecretion, weight increase, and reduction of suggestive

  7. Revascularização do miocárdio sem circulação extracorpórea em pacientes acima de 75 anos: análise dos resultados imediatos Myocardial revascularization without extracorporeal circulation in patients over 75 years of age: analysis of immediate results

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    Rodrigo Milani


    7.54±2.69%. The total number of distal anastomoses was 639. Seven (3.62% patients died, 3 due to bronchopneumonia, 1 due to mediastinitis, 1 due to metabolic causes, 1 due to cardiogenic shock, and another died suddenly after refixation of a sternal dehiscence. Reoperation due to bleeding, orotracheal reintubation, and prolonged mechanical ventilation were factors associated with an increase in mortality. CONCLUSION: The surgery adopted for myocardial revascularization was associated with a low mortality rate, a low complication index, and a short length of stay at the hospital.

  8. Pulmón hiperlucente

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    Florana Jiménez-Gutiérrez


    important to differentiate this syndrome from other causes of unilateral pulmonary hiperlucency on conventional chest x-rays. Few cases of Swyer-James Syndrome in children have been reported, we present herein the clinical case of a patient who had a Para influenza 3 bronchopneumonia when he was a month and eighteen days of age. The ensuring chest radiographs showed a hiperlucent lung. Further testing confirmed the clinical diagnosis of an unilateral hiperlucent lung.

  9. Efeito da continuidade da fisioterapia respiratória até a alta hospitalar na incidência de complicações pulmonares após esofagectomia por câncer Effect of sustained respiratory care until hospital discharge on the incidence of pulmonary complications following esophagectomy for cancer

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    Adriana Claudia Lunardi


    higher tobacco consumption than ICUg ones (35.7±17.6 vs 26.1±18.4 packs-year, p<0.05, there were 20% less pulmonary complications in this group when compared to the ICU group (10% vs 30%, p<0.05: lesser incidence (75% of pleural effusion and 50% less of bronchopneumonia. DISg also had undergone a shorter time (less 4.5 days with pleural drain on (p<0.05. These findings suggest chest physical therapy care all along hospital stay until discharge may reduce pulmonary complications after esophagectomy for cancer.

  10. Corrección quirúrgica de la coartación de la aorta: experiencia quirúrgica durante 30 años en el Hospital México

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    Eduardo Induni


    percent had common complications to this type of interventions which resolved with appropriate management. Two patients died (2.4%, one a 4 months old baby with heart failure and bronchopneumonia and the other a 23 year old with recoarctation who was reoperated for recurrent postoperative bleeding and developed multisystemic organ failure. The patch aortoplasty technique has given us very good results, it is easy to perform since it is done right in front of the surgeon and better hemostasis can be achieved, the remaining aortic tissue can and it will grow and allows for a wider luminal diameter reducing or abolishing pressure gradients across the coarcted segment.

  11. Acquired Ondine's curse: case report Maldição de Ondina adquirida: relato de caso

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    Pedro Schestatsky


    Full Text Available We report and discuss the case of a 55-year old man who presented a history of stroke as well as chronic obstructive pulmonary disease. When admitted into the emergency room, he was diagnosed with a vertebro-basilar syndrome. A brain MRI showed a hyperintense area in the lower right brainstem laterally within the medulla, which corresponds to the area of the pathways descending from the autonomic breathing control center. During hospitalization, the patient had several episodes of prolonged apnea, mainly when asleep, having often to be "reminded" to breath. A tracheostomy was then performed with the patient under mechanical ventilation. Treatment with medroxyprogesterone, fluoxetine and acetazolamide was also started. He was discharged after 64 days breathing environmental air with no apparent episodes of apnea. He returned to the emergency room in the following day with a clinical picture of aspiration bronchopneumonia, followed by septic shock and death. CONCLUSION: the Ondine's curse is one of the posterior stroke's presentation characterized by loss of automatic breathing and for the unpredictability of clinical evolution and prognosis. Such a syndrome has rarely been reported in adults and the diagnostic criteria are not consensual in the reviewed literature. Thus any dignostic confirmation should be flexible. There are many therapeutic symptomatic options in such cases, ranging from pharmacologic approach, use of bilevel positive airway pressure and implantation of diaphragmatic pacemaker.Relatamos e discutimos o caso de um paciente de 55 anos de idade que apresentara história de acidente vascular cerebral e doença broncopulmonar obstrutiva crônica. Quando admitido no setor de emergência, foi diagnosticado como vítima de síndrome vértebro-basilar. A ressonância magnética mostrou hiperintensidade no tronco inferior à direita ao nível do bulbo, o que corresponde a área das vias descendentes do centro do controle respirat

  12. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province. Caracterización y factores pronósticos de la enfermedad cerebrovascular en la Provincia de Cienfuegos.

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    Eduardo Concepción Morales


    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

    Fundamento: Las enfermedades cerebrovasculares constituyen la tercera causa de muerte y la primera de discapacidad grave del adulto en los países con sistemas de salud desarrollados similares al nuestro. Objetivo : Caracterizar a los pacientes con enfermedades cerebrovasculares y determinar las variables que influyen en su pron

  13. Reseción esofágica por cáncer, experiencia del Servicio de Cirugía de Tórax del Hospital Dr. Rafael Á. Calderón Guardia

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    José Alberto Mainieri-Hidalgo


    pain and weight loss were the most frequent symptoms but the pain was related to preexisting peptic disease or esophagitis secondary to gastric reflux. Stage IIb, III and IV patients received neoadyuvant therapy. Three of these cases did not show residual tumor and 2 had residual aortic disease. Twenty one patients had total esophagectomy and 7 patiens had partial esophagectomies with gastric anastomosis in 5 and 2 esophagojejunostomies. Major complications were respiratory distress and bronchopneumonia in 7 patients, and anastomotic leak in 2. Thirty days mortality was 10.7%. The 3 patients died with bronconeumonía and one with cervical and other thoracic leak. Seven patients developed anastomotic strictures treated with dilatations. Survival at 5 and 10 years was 31.5% and 18% respectively.

  14. Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode

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    Nagy EE


    battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset, the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the basis of the putative occupational risk, acute psychotic episode, and the success of antibiotic therapy, we registered this case as a late neuroborreliosis with atypical appearance.Keywords: Borrelia burgdorferi, neuroborreliosis, neuropsychiatric symptoms, encephalitis, anti-NMDAR

  15. Pathogenicity of Rhodococcus equi in mice, isolated from environment, human and horse clinical samples Patogenicidade atogenicidade em camundongos de isolados clí- clínicos, nicos, ambientais e humanos de Rhodococcus equi

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    Mateus M. Costa


    Full Text Available Rhodococcus equi is a facultative intracellular pathogen associated with bronchopneumonia, mesenteric lymphadenitis and enterocolitis in foals. Although R. equi is likely to be found in every horse-breeding farm, the clinical disease is unrecognized in most of them. Capsule components, equi factor, micolic acid and some products encoded by the large 85-90Kb plasmid were described as virulence factors. However, the pathogenesis of R. equi infections and the sensibility of foals are not completely understood. The aim of this study was evaluate the virulence of R. equi isolated from human, horses and environment for mices. Nine strains carrying the 85-90Kb plasmid isolated from foal clinical specimens, one from immunodeficient human patient and six plasmidless strains (four isolated from feces, one from pasture and one from immunodeficient human patient were inoculated in cyclophosphamide immunossuppressed mice. The pathological changes and viability of R. equi cells in the liver of mice was verified after the 3rd, 6th an 10th day after inoculation for horse and environmental isolates and for R. equi isolates from human patients on the 1st, 3rd and 6th day. During the necropsy procedures, infiltrate of macrophages and pyogranulomatous lesions were detected after the sixth pos-inoculation day in the liver and spleen. In horse isolates, only plasmid positive strains were virulent, but in human isolates both strains (plasmid positive e plasmid negative were virulent. Both groups of the immunossupressed mice inoculated with R. equi isolated from environment showed pathological changes. All R. equi strains were unable to kill non imunossuppressed mice.Rhodococ-cus equi é um patógeno intracelular facultativo associado com broncopneumonia, linfadenite mesentérica e enterocolite em potros. Apesar do patógeno ser amplamente distribuído no ambiente equino, a doença não é encontrada em todos os criatórios. Componentes capsulares, "fator equi",

  16. Artritis séptica no gonocóccica en el Hospital Universitario San Vicente de Paúl (1984-1992 Non-Gonococcal septic arthritis at Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 1984-1992

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    Oscar Uribe


    class="MsoNormal">Non-gonococcal septic arthritis is a rheumatological emergency; early diagnosis and treatment prevent deformities and disabilities. A retrospective study of this disease was carried out for the period 1984-1992, at Hospital Universitario San Vicente de Paúl, Medellín, Colombia; 54 patients older than 12 years were found that presented clinical manifestations of septic arthritis and in whom etiologic diagnosis was established by either joint fluid or blood culture. The following aspects were Included in the survey: form of presentation, predisposing factors, etiology and complications. There were 38 males (70.4% and 16 females (29.6%; average age was 27 years. The disease was monoarticular In 49 cases (90.7% and affected 2 joints In 5; In decreasing order of frequency the following joints were Involved: knee (30 cases; 55.6%; hip (19 cases; 35.2%, ankle and shoulder (3 cases each, sacroiliac joint (2 cases, metacarpophalangic and sterno clavicular joints (1 case each. The infection was due to Staphylococcus aureus in 43 cases (79.6% followed by Gram-negative bacilli (9 cases; 16.7%; the remaining 2 cases were streptococcal. Complications were sepsis (13 cases, ostomyelitis (13 cases, bronchopneumonia (6 cases, renal insufficiency (3 cases, Intravascular disseminated coagulation (1 case and pericarditis (1 case; these 37 complicating events occurred In 23 patients. Predisposing factors and underlying diseases were as follows: soft tissue infection (9 , patients, endometritis (3 patients, systemic erythematous lupus (2 patients, non-Hodgkin Iymphoma (2 patients, rheumatoid arthritis and intra-articular Injection (1 patient each. Evolution had been longer than one week In 43 patients (79.6% when they first attended the Hospital; despite the delay there were no fatalities.

  17. 761例住院儿童EB病毒感染分析%Analysis of Epstein Barr virus infection in 761 hospitalized children

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    陈倩; 胡正; 张其华


    in winter (P < 0. 05). The range of plasma EBV-DNA level in children with EBV-DNA positivity was 2. 13 to 6.69 (median 3.72). Based on the final diagnosis of 62 EBV-positive hospitalized children, the most common disease was respiratory system infection ( 39% ) , such as acute bronchitis, acute upper respiratory infection and bronchopneumonia. Conclusions The EBV-DNA positive rate is different among different age groups and between seasons. Respiratory system infection is a leading disease in hospitalized children who are EBV-DNA positive. Real-time PCR assay is useful for rapid and reliable clinical diagnosis of EBV in children.

  18. Clinical characteristics of human coronavirus in children with acute lower respiratory tract infection%人冠状病毒在急性下呼吸道感染儿童中的临床特征

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    刘军; 谢正德; 徐保平; 钱素云; 杨燕; 申昆玲


    Objective To describe the clinical characteristics of acute lower respiratory tract infection (ALRTI)caused by human coronavirus (HCoV)in children.Methods Three thousand five hundred and three hospi-talized children diagnosed with ALRTI in Beijing Children′s Hospital from March 2007 to February 201 3 were re-viewed.Nasopharyngeal aspirate(NPA)specimen was collected from each patient.Reverse transcription (RT)-poly-merase chain reaction(PCR)methods were applied to detect common respiratory viruses including respiratory syncytial virus (RSV),rhinovirus (RV),parainfluenza virus (PIV)type 1 -4,influenza virus type A and B (IFA,IFB),adeno-virus (AdV),enterovirus (EV),HCoV,human metapneumovirus (hMPV)and human bocavirus (HBoV).Serum anti-bodies of mycoplasma and sputum bacterial culture were also detected.Only HCoV positive patients were analyzed in this study.Results Eleven of 3 503 patients were proved as HCoV -positive in NPA specimens.Of the 1 1 children,8 cases were male and 3 cases were female (2.71 .0).The median age was 3 months.The clinical symptoms of HCoV infection included cough (1 1 /1 1 cases,1 00.0%),wheezing (1 0 /1 1 cases,90.9%),fever (6 /1 1 cases,54.5%)and poor appetite (7 /1 1 cases,63.6%).Wheezing (8 /1 1 cases,72.7%)and moist rale in inspiratory phase (5 /1 1 ca-ses,45.4%)could be heard.Most patient′s chest X -ray showed bronchopneumonia.Full blood count displayed that leukocyte was in the normal range.Conclusions Respiratory tract infection with HCoV -positive will be easier to spread to ALRTI,especially in infants less than 1 year old.The symptoms include fever,cough and wheezing,but poor appetite and diarrhea can also be detected.%目的:了解急性下呼吸道感染住院患儿人冠状病毒(HCoV)感染的临床表现。方法回顾性分析2007年3月至2013年2月在北京儿童医院因下呼吸道感染住院的患儿3503例,患儿在住院当日或次日采集鼻咽吸取物1份,采用反转录(RT)-PCR 方法进行

  19. Clinical features of human parainfluenza virus type 3 (HPIV3) infection in Suzhou area%苏州地区人副流感病毒3感染住院患儿临床特征

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    赵显虹; 王宇清


    positive rate of HPIV3 was 4. 26% (98 cases), and 10. 14% of postive ferior RSV (233 cases). HPIV3 infection could occur all the year around but most seen in spring and summer, with the highest incidence of 45. 92% in summer. The highest detection rate (60. 20%) occurred in pa-tients aged from 1 to 12 months, almost younger than 6 years old. 61 cases were the only pathogen of HPIV3. Cough (96. 72%), wheezing (44. 26%) and fever (47. 54%) were more common in patients with HPIV3. The percentage of bronchopneumonia caused by HPIV3 infection was 80. 33%. Compared with RSV infection, HPIV3 had a less in-cidence of wheezing (P<0. 05). Conclusion HPIV3 is one of the most importment viral pathogens in children with respiratory infection in Suzhou area. Infection can be caused by HPIV3 only. The occurrences of season and clinical feature of HPIV3 infection are difference with RSV infection.

  20. Dolor torácico y cardiopatía en la edad pediátrica

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    Rafael Gutiérrez Alvarez


    describe the findings according with the utilized diagnostic methods. Materials and methods: This is a prospective, descriptive and analytic study of 70 patients (3 to 13 years referred to the Cardiology Clinic of the Hospital Nacional de Niños, during a one year period. Every patient had a clinical history, a physical exam, a chest x-ray and ECG and an echocardiogram taken. Results: Only 62 patients completed all their evaluating tests, 3 4 (54.5% boys and 28 (45.2% girls. The mean age was 8.5 years and the median was 9 years. In 21% of the cases the chest x-ray was abnormal (6 showed bronchopneumonia, 2 air trapping, 2 pulmonary artery enlargement, 2 prominent hila and 2 cardiomegaly. The ECG was normal in 97%, the Echocardiogram was abnormal in 4 (1 showed and ASD, 1 a patent ductus arteriosus, 1 a dysplastic pulmonic valve and 1 a pericardial effusion. Stress tests and Holters were normal. Only 4.8% of the patients had heart disease. Conclusion: Consultation for chest pain in the pediatric age is frequent. History and physical examination are very important for the diagnosis and handling of these children. Chest pain though is infrequently associated with cardiac anomalies during childhood years and the patients with heart conditions and chest pain had other findings such as bradychardia, pericardial rub and murmurs.

  1. Sorotipagem de amostras de Streptococcus suis isoladas de suínos em granjas dos Estados de São Paulo, Minas Gerais e Paraná Serotyping of Streptococcus suis strains isolated from pigs in the States of São Paulo, Minas Gerais e Paraná, Brazil

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    Keila J.R. Pagnani


    -aglutinação, para a sorotipagem das amostras de S. suis. A sorotipagem das 51 amostras isoladas mostraram os seguintes resultados: 30 (58,8% foram classificadas como sorotipo 2, 11 (21,6% das amostras como sorotipo 3, sete (13,72% como sorotipo 7, duas (3,92% como sorotipo 1 e uma amostra como pertencente ao sorotipo14 (1,96%. Este é o primeiro relato do isolamento de um grande número de amostras de S. suis no Brasil, de casos típicos de processos infecciosos causados por esta bactéria. Também foi realizada a sorotipagem dos isolados, mostrando uma alta prevalência do sorotipo 2, quando comparada com a dos demais sorotipos encontrados.Streptococcus suis infection in swine is common in all countries where hog production is well developed. This infection has been associated with bronchopneumonia, meningitis, arthritis, pericarditis, myocarditis, endocarditis, fibrinous polyserositis, septicaemia, rhinitis, and abortion. Streptococcus suis has also been described as a pathogen for ruminants and humans. In Brazil there are several clinical evidences about the existence of S. suis disease in pigs affecting more than 50% of farms in States of São Paulo, Minas Gerais and Paraná. In the present research 51 strains of S. suis isolated from piggeries of the States of São Paulo, Minas Gerais and Paraná were collected from different pathologies such as septicaemia, meningitis, arthritis and pneumonia and been recovered either in pure culture or as the predominant organism from porcine tissues. Culture of specimens was carried out on 5% bovine blood agar plates incubated at 37°C for 24 hr. For the biochemical identification the a-hemolytic colonies of all capsulated isolates were submitted to various conventional tests, such as hydrolysis of arginine, Voges-Proskauer Test, and production of acid from various carbohydrates (inulin, salicin, trehalose, lactose, sucrose, sorbitol, mannitol and glycerol. The strains were also tested for their ability to grow in the presence of 6,5% Na

  2. Implante transapical de endoprótese valvada balão-expansível em posição aórtica sem circulação extracorpórea Off-pump transapical balloon-expandable aortic valve endoprosthesis implantation

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    Diego Felipe Gaia


    ão.OBJECTIVE: The aortic valve replacement is a routine procedure, and involves replacement of the native valve/prosthesis. In most of the patients who undergo such procedure the risk is acceptable, but in some cases, such risk can justify contraindication. The minimally invasive transcatheter aortic valve implantation without cardiopulmonary bypass (CPB has been shown to be viable, with lower morbidity and mortality. The aim of this study was to develop a catheter-mounted aortic bioprosthesis for implantation without CPB. METHODS: After developing in animals, three patients with high EuroSCORE underwent implantation. Case 1: patients with bioprosthesis dysfunction; Case 2: severe aortic stenosis; Case 3: dysfunction of aortic bioprosthesis. After minithoracotomy and under echocardiographic and fluoroscopic control, a balloon catheter was placed on aortic position and inflated. After, a second balloon with valved endoprosthesis was positioned and released under high ventricular rate. Echocardiographic and angiographic controls were performed and the patients were referred to ICU. RESULTS: In the first case, implantation without CPB was possible with appropriate results. The patient evolved with improvement of ventricular function. After, this patient developed bronchopneumonia, tracheoesophageal fistula and died due to mediastinitis. Autopsy confirmed proper valve positioning and leaflets preservation. The second case showed the device migration after inflation of the balloon, with the need for urgent median sternotomy, CPB and conventional valve replacement. This patient evolved well and was discharged from the ICU on the 14th postoperative day without complications. This patient developed respiratory infection, septic shock and died on the 60th postoperative day. The patient from the third case underwent successful implantation. CONCLUSION: The off-pump transapical implantation of catheter-mounted bioprosthesis was shown to be a feasible procedure. Technical details and learning

  3. Síndrome antissintetase anti-Jo-1 Anti-Jo-1 antisynthetase syndrome

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    Samuel Katsuyuki Shinjo


    . Clinical-laboratory and demographic data were obtained from medical files. All patients fulfilled the Bohan and Peter criteria (1975 and presented anti-Jo-1, articular, muscle and lung involvement. Eighteen patients with anti-Jo-1 ASS were analyzed. RESULTS: The mean age at disease onset was 39.9 ± 15.7 years and average disease duration was 9.7 ± 7.0 years. All subjects were white, and 94.4% were female. Constitutional symptoms occurred in 50 % of cases. There was cutaneous and gastrointestinal tract involvement in 66.6% and 55.6% of cases, respectively. No cases manifested neurologic or cardiac involvement. Half of the patients showed incipient pneumopathy, ground-glass opacities and basal pulmonary fibrosis. There was one case of tuberculosis, three of herpes zoster and one of non-Hodgkin lymphoma. One death occurred due to sepsis shock (hospital bronchopneumonia. All patients received prednisone (1mg/kg/day and 12 (66.7% participants received methyl prednisolone pulse therapy (1g/day, 3 days. Various immunosuppressants were used as corticosteroid tapers, depending on tolerance, side effects and/or refractoriness. Although disease relapse (clinical and/or laboratory occurred in 87.5% of cases, 12 out of 16 patients (75% were in disease remission at study endpoint. CONCLUSION: In the present study, almost all patients were white females and the disease relapse rate was high.

  4. Clonidina como droga adjuvante no tratamento da síndrome de abstinência alcoólica em unidade de terapia intensiva: relato de caso Clonidina como droga coadyuvante en el tratamiento de la síndrome de abstinencia alcohólica en unidad de terapia intensiva: relato de un caso Clonidine as adjuvant therapy for alcohol withdrawal syndrome in intensive care unit: case report

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    Leandro Gobbo Braz


    alta de la UTI. CONCLUSIONES: La droga escogida para el tratamiento del síndrome de abstinencia alcohólico es el benzodiazepínico. No obstante, en el presente relato, solamente el uso coadyuvante de clonidina consiguió proporcionar tratamiento adecuado al paciente.BACKGROUND AND OBJECTIVES: Sedation of patients with past history of alcohol and drug abuse in Intensive Care Units (ICU is a challenge due to the high incidence of sedative drugs tolerance and withdrawal syndromes. This report aimed at describing a case of a young patient admitted to the ICU who developed alcohol withdrawal syndrome and tolerance to sedatives, resolved only after clonidine administration. CASE REPORT: Male patient, 18 years old, alcohol, tobacco, cocaine and marijuana abuser, victim of firearm accident, who was admitted to the ICU in the first post-enterectomy day, after gastric content aspiration during tracheal re-intubation. Clinical evolution was: vasoactive drugs up to the 4th day; bilateral bronchopneumonia with pleural effusion and need for artificial ventilation up to the 15th day. Initial sedation scheme was the association of midazolam and fentanyl. As from the 4th day, patient presented with several psychomotor agitation episodes, even after the association of lorazepam in the 6th day. In the 9th day, patient received the largest doses but remained agitated. Dexmedetomidine was associated, which has decreased other drug doses in 35% and has improved agitation. In the 12th day, midazolam and dexmedetomidine were replaced by propofol infusion with worsening of agitation. In the 13th day, clonidine was associated to the sedation scheme with total resolution of agitation. Propofol was withdrawn in the 14th day, fentanyl was maintained and midazolam infusion was restarted, with doses 75% and 65% lower as compared to peak doses of such drugs. Patient was extubated in the 15th day and was discharged from ICU. CONCLUSIONS: Benzodiazepines should remain the drugs of choice for the

  5. Clinical analysis of 165 cases whose bronchoalveolar lavage lfuid bacterial culture were positive%支气管肺泡灌洗液细菌培养阳性患儿165例临床分析

    Institute of Scientific and Technical Information of China (English)

    李海燕; 余璐; 叶乐平; 杨锦红; 董琳; 李昌崇


    Objective: To investigate the clinical characteristics, pathogen spectrum and antibiotic drug sensitive test of patients whose bronchoalveolar lavage lfuid culture were positive. To provide the theory basis for clinical diagnosis and treatment for lower respiratory infection in children.Methods: A retrospective review was performed on 1 159 hospitalized cases from January 1, 2013 to December 31, 2015. The information of the patients whose BLAF were sent to lab including clinical data, bacterial culture and drug sensitivity was ana-lyzed.Results: The bacterial culture of BALF in 165 cases were positive, among whom 99(60.0%) were male and 66(40.0%) female. Overall, 70.4% cases were suffered from pneumonia, especially bronchopneumonia. 19 cases (11.5%) were diagnosed as bronchiolitis and combined with bacterial infection. And 12 cases (7.3%) had protracted bacterial bronchitis. One hundred and sixty ifve organisms from BALF were collected in the survey period, including 112(67.9%) gram-positive bacteria and 53(32.1%) gram-negative bacteria. The ifve most fre-quently isolated pathogens wereStreptococcus pneumoniae (102 strains),Haemophilus inlfuenza (14 strains), Pseudomonas aeruginosa (13 strains),Escherichia coli (8 strains) andStraphylococcus aureus (8 strains). Sixty ifve cases (39.4%) had underlying disease and the most common one was deformity of respiratory tract (22 cases) such as malacia, stenosis of trachea or bronchus. There were 14 cases suffered from bronchial asthma. Among 102Streptococcus pneumoniae strains, there were 25 strains penicillin-sensitiveS. pneumoniae, 35 strains pen-icillin-intermediateS. pneumonia and 42 penicillin-resistantS. pneumonia. MostStaphylococcus aureus strains were methicillin-resistant and there was no vancomycin and linezolid-resistant strain. The drug resistant rates ofHaemophilus inlfuenzae to penicillin and the second generation of cephalosporin were high. However, it was sensitive to the third generation of cephalosporin

  6. Perfil de internações hospitalares por doenças respiratórias em crianças e adolescentes da cidade de São Paulo, 2000-2004 Perfil de internaciones hospitalares por enfermedades respiratorias en niños y adolescentes de la ciudad de São Paulo, 2000-2004 Hospital admissions due to respiratory diseases in children and adolescents of São Paulo city, 2000-2004

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    Renata Martins de T Natali


    described. RESULTS: Pneumonia and bronchopneumonia (51%, asthma (18% and acute and chronical diseases from upper airways (10% accounted for most of the admissions. Children up to five years are most frequently hospitalized, regardless of the specific cause. Among adolescents, the main causes of hospitalization were respiratory diseases that affects mainly the interstitial lung (0.1% and the necrotic and suppurative diseases of lower airways (0.2%. From the age of six to ten years, admissions for acute and chronic diseases from upper airways (10% were predominant. The peak of morbidity occurs in early autumn. There was a trend towards increasing hospital admissions for respiratory illnesses during the analyzed period. CONCLUSIONS: The distribution of hospital admissions for respiratory diseases in children and adolescents is dependent on age and season. The younger the age the greater the number of hospital admissions.

  7. 儿童闭塞性细支气管炎26例临床研究%Clinical characteristics of bronchiolitis obliterans in pediatric patients

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    陈德晖; 徐佳兴; 龚小燕; 钟南山; 林育能; 蓝淑玲; 潘小安; 曾庆思; 何振涛; 梁铭; 张碧云; 吴上志


    断的信息,HRCT提示的典型马赛克征是诊断BO的重要征象.约50%患儿ANCA阳性,提示BO患儿可能存在免疫损伤.口服全身激素及甲氨蝶呤可改善临床症状,但整体治疗效果不理想.%Objective To analyze the clinical characteristics,image findings,laboratory examination,the therapeutic methods and clinical outcomes of bronchiolitis obliterans (BO) in pediatric patients.Method Twenty-six pediatric patients with BO were reported.All data were collected from cases who were hospitalized in the Department of Pediatrics,First Affiliated Hospital of Guangzhou Medical College from June 1st,2009 to the April 30th,2011,and infectious agents,clinical manifestations,risk factors,changes in imageology,laboratory examination,therapeutic methods and treatment responses were analyzed.Result The ranges of age at onset was 4.5 months-8 years in 26 cases ( 18 boys and 8 girls).The course of disease was (6.2 ± 3.5 ) months.The period of followed-up ranged from 2 to 24 months.The common clinical characteristics were persistent wheezing of different severity (26 cases,100% ),cough (24 cases,92% ),intolerance to exercise ( 22 cases,85% ),short of breath (21 cases,81% ),retraction:(20 cases,77% ),wheezy phlegm (16 cases,62% ),keeping with crackles ( 10 cases,38% ),cyanosis around the mouth (3 cases,12% ) and no clubbed fingers (toes).In 18 cases the etiology was detected,mycoplasma (11 cases,42%),respiratory syncuial virus (4 cases,15%),parainfluenza virus (2 cases,8%),influenza virus A (2 cases,8% ) and influenza virus B (2 cases,8% ),human bocavirus (HBoV) (1case,4%). There were 8 cases (31%) with combined infection. Chest X-ray in 10 cases indicated changes suggestive of bronchopneumonia (38%),in only 1 case there was an image of interstitial pneumonia disease (4%).All the patients were diagnosed by high-resolution computerized tomography (HRCT).All cases were demonstrated to have air retention,poor blood

  8. Human parechovirus associated sepsis and central nervous system infections in hospitalized children%人副肠孤病毒与儿童脓毒症和中枢神经系统感染的相关性

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    罗雷; 朱汝南; 赵林清; 邓洁; 王芳; 孙宇; 宋秦伟; 丁雅馨; 钱渊


    V3 were younger than 3 months and were diagnosed as sepsis,while the rest of HPeV3 positive children were diagnosed as meningitis and bronchopneumonia.HPeV3 infection clustered in August,while HPeV1 in January.Conclusion HPeVs were associated with CNS infections and sepsis in hospitalized children in Beijing,especially in children younger than one year.HPeV3 was the predominant type identified in CSF.

  9. Etiology of acute respiratory tract infection in hospitalized children in Suzhou from 2005 to 2011%2005-2011年苏州地区急性呼吸道感染住院儿童病原学研究

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    季伟; 陈正荣; 周卫芳; 孙慧明; 李蓓荃; 蔡利红; 严永东


    children with MP (30 months),streptococcus pneumoniae (17 months) or haemophilus parainfluenzae (21 months) infection was older than it of all hospitalized children (x2 =728.299,60.463,8.803,P < 0.05).The detected rate of RSV in the groups of children aging less than 6 months,7-12 months,2-3 years,4-5 years and over 6 years was separately 25.59% (840/3283),17.05%(333/1953),11.85% (310/2615),6.68% (90/1347),and 2.87% (30/1045) ; which decreased while the age grew (x2 =178.46,P < 0.01).Conversely,the positive rate of MP increased with the age growing (x2 =379.21,P < 0.01).The rate in the above groups was 8.25% (271/3283),19.46% (380/1953),33.00% (863/2615),41.43% (558/1347),54.07% (565/1045),respectively.RSV and IV-A were prevalent in winter,whose detected rates were 35.73% (941/2634) and 4.44% (117/2634)respectively.hMPV infection was common in spring,with the detected rate at 10.55% (278/2634) ; while HBoV infection was common in summer and autumn,with the positive rate at 9.99% (149/1491) and 9.71% (98/1009).MP and CP were frequently detected in summer,up to 31.27% (819/2619) and 10.07% (43/427) respectively.RSV was the most common pathogen in bronchiolitis (33.27%(866/2603)) and MP was the most common pathogen in bronchopneumonia (26.05% (1152/4422)) and lober pneumonia (52.25 % (267/511)).Conclusion MP and RSV were the most common pathogens in respiratory tract infection in hospitalized children.The novel virus included hMPV and HBoV,which also played an important role in ARI.Different pathogens were prevalent in different ages; with respective seasonal distribution and characteristics.%目的了 解2005-2011年苏州地区急性呼吸道感染(ARI)住院患儿的病原检出情况.方法 选取苏州地区2005年9月至2011年10月因ARI在苏州大学附属儿童医院住院治疗的患儿作为研究对象,共10 243例.收集患儿临床资料,同时采集鼻咽部分泌物及血清标本进行多病原检测.应用直